The Role of Serum Procalcitonin as a Diagnostic and Prognostic Biomarker for Sepsis in Major Burn Patients: A Prospective Study

Abstract

Background: Sepsis in burns worsens the patient’s prognosisand increases the risk of organ failure and death. Multipleorgan dysfunction syndrome (MODS), which is a directresponse to sepsis is the main reason for death in burn patients.Identifying early sepsis is especially important, given thatevery 6h delay in the diagnosis of sepsis reduces survival by10%. Complexity in diagnosing sepsis in the burn is due tothe systemic response to the burn itself clinically simulatingsepsis.Objective: The aim of this study is: To investigate the diagnosticvalidity of PCT in burn sepsis as an early diagnostictool and to identify its prognostic value in major burn patientswith sepsis.Patients and Methods: The study was a prospective studythat was conducted in a six months period carried out in theBurn Intensive Care Unit (ICU) of Ain Shams University Hospitalson 30 patients that were admitted from October 2021 toMarch 2022 with major burn (more than 20% of TBSA) wereincluded, the Local Ethics Committee approved the study, andinformed consent was obtained from all participants or theirguardians.Results: It had been revealed that the first 3 samples thatwere drowned on admission and after 24 hours and then on day3 of admission have no significant increase in PCT levels inrelation to sepsis. However, the following 2 samples which hadbeen withdrawn on day 5 show a significant increase in PCTlevels, and these on day 7 are highly significant with a median(IQR) range of 9ng/dl and median (IQR) range of 13.2ng/dlrespectively. Moreover, it had been noted that the PCT levelon admission was significant for the prognosis of death with amedian (IQR) range of 1.65ng/dl while in survivor patients themedian was 0.45ng/dl.Conclusion: Our study demonstrated that PCT level in majorburn patients is a promising diagnostic biomarker in detectingsepsis that could facilitate ideal management and initiateproper antimicrobial therapy and good prognostic value as anearly predictor of mortality.