Accuracy of Day 1 Procalcitonin and C-Reactive Protein Levels for Predicting Mortality in Burn Patients
DOI:
https://doi.org/10.70749/ijbr.v3i7.2072Keywords:
burn injuries, mortality, CRP levels, procalcitonin, sensitivityAbstract
Objective: Although serum procalcitonin (PCT) and C-reactive protein (CRP) are currently used to predict infection, sepsis, and death in intensive care units, their application in burn mortality has received little attention. Thus, it is essential to do study on how day-one PCT and CRP patterns affect burn mortality. Study design: Cross-sectional study. Settings: Department of Plastic Surgery, Nishtar Medical University, Multan. Duration of study: January 2024 to May 2024. Methodology: Total 111 patients, both male and female, aged 18 to 60, within 48 hours of a thermal burn injury, with 20–60% of their total burn surface area free of inhalational injuries were included. Based on their medical history and medical records, patients with concomitant chronic diseases were not included. Venous blood samples were obtained aseptically on the first day of hospitalization and sent for CRP analysis; a cutoff of 71 mg/dl was used to predict mortality. PCT determination (PCT cutoff of 1770 ng/ml was used to predict mortality) and a level > 71 predicted mortality and <71 predicted survival. < 1770 predicted survival and >1770 projected mortality. The ultimate outcome (survivor or non-survivor) was recorded. Results: Day 1 CRP levels provide a 93.62% sensitivity, 93.75% specificity, 91.67% PPV, 95.24% NPV, and 93.69% diagnostic accuracy for predicting burn patient mortality. 90.99% diagnostic accuracy, 91.49% sensitivity, 90.62% specificity, 87.76% PPV, 93.55% NPV, and day 1 procalcitonin levels for burn patient mortality prediction. Conclusion: A poor prognosis is linked to increasing trends in serum PCT and CRP levels in patients with burn injuries.
Downloads
References
1. Yakupu A, Zhang J, Dong W, Song F, Dong J, Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health. 2022;22(1):1596.
https://doi.org/10.1186/s12889-022-13887-2
2. Edgar MC, Bond SM, Jiang SH, Scharf IM, Bejarano G, Vrouwe SQ. The revised Baux score as a predictor of burn mortality: a systematic review and meta-analysis. J Burn Care Res. 2023;44(6):1278-88.
https://doi.org/10.1093/jbcr/irad075
3. Güney D, Doruk H, Ertürk A, Öztorun Cİ, Demir S, Erten EE, et al. Analysis of risk factors of mortality for pediatric burned patients with inhalation injury and comparison of different treatment protocols. Ulus Travma Acil Cerrahi Derg. 2022;28(5):585-92.
4. Yiğit E, Yiğit YD. Diagnostic importance of serum C-reactive protein and procalcitonin in sepsis after burn. Int J Burns Trauma. 2021;11(5):391-6.
5. Doddikoppad P, Joshi DN, Shenoy B. Procalcitonin: In diagnosis of paediatric infections. Karnataka Paediatr J. 2022;37(2):41-5.
https://doi.org/10.25259/kpj_20_2022
6. Gille J, Schmidt J, Kremer T, Sablotzki A. Evaluation of MR-proANP and copeptin for sepsis diagnosis after burn injury. J Crit Care. 2019;52:149-55.
https://doi.org/10.1016/j.jcrc.2019.04.031
7. Bruserud Ø, Aarstad HH, Tvedt TH. Combined C-reactive protein and novel inflammatory parameters as a predictor in cancer—what can we learn from the hematological experience?. Cancers. 2020;12(7):1966.
https://doi.org/10.3390/cancers12071966
8. State M, Negreanu L, Voiosu T, Voiosu A, Balanescu P, Mateescu RB. Surrogate markers of mucosal healing in inflammatory bowel disease: a systematic review. World J Gastroenterol. 2021;27(16):1828-40.
https://doi.org/10.3748/wjg.v27.i16.1828
9. Sinha A, Sharma MK, Tripathi K, Duggal N, Tiwari VK. Evaluation of serum levels of procalcitonin and C-reactive protein as prognostic indicators in burns. Indian J Plastic Surg. 2021;54(03):308-13.
https://doi.org/10.1055/s-0041-1734574
10. Pham HM, Nguyen DLM, Duong MC, Phan XT, Tran LT, Trang DHT, et al. Neutrophil CD64-a prognostic marker of sepsis in intensive care unit: A prospective cohort study. Front Med (Lausanne) 2023;10:1251221.
https://doi.org/10.3389/fmed.2023.1251221.
11. Abdelshafey EE, Nasa P, Elgohary AE, Khalil MF, Rashwan MA, Ghezala HB, et al. Role of presepsin for the diagnosis of sepsis and ICU mortality: A prospective controlled study. Indian J Crit Care Med. 2021;25(2):153–157.
https://doi.org/10.5005/jp-journals-10071-23715.
12. Vassallo M, Michelangeli C, Fabre R, Manni S, Genillier PL, Weiss N, et al. Procalcitonin and C-reactive protein/procalcitonin ratio as markers of infection in patients with solid tumors. Front Med (Lausanne) 2021;8:627967.
https://doi.org/10.3389/fmed.2021.627967.
13. Oncul U, Dalgıç N, Demir M, Karadeniz P, Karadağ ÇA. Use of procalcitonin as a biomarker for sepsis in pediatric burns. Eur J Pediatr. 2023;182(4):1561-7.
https://doi.org/10.1007/s00431-023-04831-6
14. Ryu J-A, et al. Clinical usefulness of procalcitonin and C-reactive protein as outcome predictors in critically ill patients with severe sepsis and septic shock. PLoS ONE. 2015;10(9):e0138150.
https://doi.org/10.1371/journal.pone.0138150
15. Yigit E, Demir Yigit Y. Diagnostic importance of serum C-reactive protein and procalcitonin in sepsis after burn. Int J Burns Trauma. 2021;11(5):391–6.
16. Tan M. The diagnostic accuracy of procalcitonin and C-reactive protein for sepsis: a systematic review and meta-analysis. J Cell Biochem. 2019;120(4):5852–9.
https://doi.org/10.1002/jcb.27870
17. Gregoriano C. Role of procalcitonin use in the management of sepsis. J Thorac Dis. 2020;12(Suppl 1):S5.
https://doi.org/10.21037/jtd.2019.11.63
18. Tan J. Procalcitonin kinetics early after severe burn injury and its value in diagnosis of sepsis. Burns. 2021;47(8):1802–9.
https://doi.org/10.1016/j.burns.2021.02.024
19. Jerome E, McPhail MJ, Menon K. Diagnostic accuracy of procalcitonin and interleukin-6 for postoperative infection in major gastrointestinal surgery: A systematic review and meta-analysis. Ann R Coll Surg Engl. 2022;104(8):561–570.
https://doi.org/10.1308/rcsann.2022.0053.
20. Lai L, Lai Y, Wang H, Peng L, Zhou N, Tian Y, et al. Diagnostic accuracy of procalcitonin compared to c-reactive protein and interleukin 6 in recognizing gram-negative bloodstream infection: A meta-analytic study. Dis Markers. 2020;2020:4873074.
https://doi.org/10.1155/2020/4873074.
21. Lee S, Song J, Park DW, Seok H, Ahn S, Kim J, et al. Diagnostic and prognostic value of presepsin and procalcitonin in non-infectious organ failure, sepsis, and septic shock: A prospective observational study according to the Sepsis-3 definitions. BMC Infect Dis. 2022;22(1):8.
https://doi.org/10.1186/s12879-021-07012-8.
22. Piroglu ID. Do early procalcitonin levels aid in predicting mortality in burn patients. Int J Clin Exp Med. 2016;9(03):6497–503.
23. Xu L. Elevated serum procalcitonin early after extensive burn: influencing factors and clinical significance. Burns. 2021;47(6):1399–407.
https://doi.org/10.1016/j.burns.2020.12.010
24. Fan L, Ding X. Procalcitonin and C-reactive protein/procalcitonin ratio for distinguishing between infectious and neoplastic fever in cancer patients. Altern Ther Health Med. 2023;29(7):365–369. 37535912.
25. Cho J, Jeong S, Lee JH. Procalcitonin to C-reactive protein ratio is associated with short-term mortality in ischemic stroke patients: Preliminary report. Arch Med Sci. 2022;18(2):344–352.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
