PCT as a diagnostic and prognostic tool in burn patients. Whether time course has a role in monitoring sepsis treatment
PCT as a diagnostic and prognostic tool in burn patients. Whether time course has a role in monitoring sepsis treatment
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DOI：
10.1016/j.burns.2011.08.021
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发表时间：
2012-05-01
期刊：
影响因子：
2.7
通讯作者：
Bitzani, M.
中科院分区：
文献类型：
--
作者：
Lavrentieva, A.;Papadopoulou, S.;Bitzani, M.
目的：为了评估脓毒性和非脓毒性（局部）细菌感染的炎症标志物的诊断和预后性能在severityburn.Methods和结果：145例患者的数据前瞻性纳入本研究。烧伤后24 h内及以后每天测定血清降钙素原及其他炎性标志物。最大降钙素原（p = 0.004）是logistic回归分析结果的独立预测因子。PCT阈值为1.5 ng/ml、0.52 ng/ml和0.56 ng/ml分别对脓毒症、呼吸道和伤口感染有足够的敏感性和特异性。第3天PCT浓度阈值7.8 ng/ml与脓毒症治疗有效性相关，AUC为0.86（95% CI 0.69-1.03，p = 0.002）。C-反应蛋白水平和白细胞数在治疗成功的患者中在前3天内无显著变化（p = 0.93）。结论：最大降钙素原水平对烧伤患者有预后价值。PCT可用作ICU住院期间感染并发症伴或不伴菌血症患者的诊断工具。每日连续PCT测量可能是监测烧伤ICU患者抗生素治疗有效性的有价值的工具。(C)2011 Elsevier Ltd和ISBI。All rights reserved.
Objective: To evaluate the diagnostic and prognostic performance of inflammatory markers for septic and non septic (localized) bacterial infections in patients with severe burn.Methods and results: Data of 145 patients were prospectively included in this study. Serum procalcitonin and other inflammatory markers were measured within 24 h after burn and daily thereafter. Maximum procalcitonin (p = 0.004) was independent predictors of outcome in logistic regression analysis. PCT thresholds of 1.5 ng/ml, 0.52 ng/ml and 0.56 ng/ml had adequate sensitivity and specificity to diagnose sepsis, respiratory tract and wound infections respectively. A threshold value of 7.8 ng/ml in PCT concentration on day 3 was associated with the effectiveness of the sepsis treatment with an AUC of 0.86 (95% CI 0.69-1.03, p = 0.002). C-reactive protein levels and WBCs showed no significant change over the first 3 days in the patients with successfully treated sepsis (p = 0.93).Conclusion: The maximum procalcitonin level has prognostic value in burn patients. PCT can be used as a diagnostic tool in patients with infectious complications with or without bacteremia during ICU stay. Daily consecutive PCT measurements may be a valuable tool in monitoring the effectiveness of antibiotic therapy in burn ICU patients. (C) 2011 Elsevier Ltd and ISBI. All rights reserved.