Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns

Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to...

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Main Authors: Zhaoxing Liu, Dawei Li, Xinzhu Liu, Bohan Zhang, Yu Zang, Jinglong Ma, Wen Zhang, Yuezeng Niu, Chuanan Shen
Format: Article
Language:English
Published: Taylor & Francis Group 2022-07-01
Series:Journal of Investigative Surgery
Subjects:
Online Access:http://dx.doi.org/10.1080/08941939.2022.2073489
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author Zhaoxing Liu
Dawei Li
Xinzhu Liu
Bohan Zhang
Yu Zang
Jinglong Ma
Wen Zhang
Yuezeng Niu
Chuanan Shen
author_facet Zhaoxing Liu
Dawei Li
Xinzhu Liu
Bohan Zhang
Yu Zang
Jinglong Ma
Wen Zhang
Yuezeng Niu
Chuanan Shen
author_sort Zhaoxing Liu
collection DOAJ
description Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.
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spelling doaj.art-99a4f084656a4b94a1fe7dd2eb95441a2023-09-15T10:21:30ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532022-07-013571510151810.1080/08941939.2022.20734892073489Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive BurnsZhaoxing Liu0Dawei Li1Xinzhu Liu2Bohan Zhang3Yu Zang4Jinglong Ma5Wen Zhang6Yuezeng Niu7Chuanan Shen8Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalDepartment of Burns and Plastic Surgery, The Fourth Medical Center of PLA General HospitalPurpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.http://dx.doi.org/10.1080/08941939.2022.2073489burnprocalcitoninseveritysepsisprognosis
spellingShingle Zhaoxing Liu
Dawei Li
Xinzhu Liu
Bohan Zhang
Yu Zang
Jinglong Ma
Wen Zhang
Yuezeng Niu
Chuanan Shen
Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
Journal of Investigative Surgery
burn
procalcitonin
severity
sepsis
prognosis
title Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
title_full Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
title_fullStr Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
title_full_unstemmed Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
title_short Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns
title_sort elevated serum procalcitonin to predict severity and prognosis of extensive burns
topic burn
procalcitonin
severity
sepsis
prognosis
url http://dx.doi.org/10.1080/08941939.2022.2073489
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