Procalcitonin in the Burn Unit and the Diagnosis of Infection

Objective: To determine the usefulness of procalcitonin (PCT) in decision-making when faced with suspected infection in patients with extensive burns. Study: Retrospective, observational follow-up study. Institution: Burn Unit of the Complex Hospitalario Universitario A Coruna (CHUAC), Spain. Patients and method: We included all patients admitted to the Unit from June 2011 to March 2012 with >= 20% total body surface area burned or >= 10% full-thickness body surface area burned with suspected infection (17 patients with 34 events of suspected infection). Results: The infections were confirmed in 16/34 episodes (47.1%), and documented in 44.1% (n = 15). There were no statistically significant differences in the PCT figures at the time the infection was suspected between the cases with confirmed and unconfirmed infection (p = 0.682). The PCT values showed no discriminative value for differentiating patients with SIRS from those with sepsis, severe sepsis and septic shock (area under ROC curve (AUC) = 0.546; 95% CI: 0.326-0.766). No significant correlation was found between SOFA and PCT, although there were differences in the PCT values in the patients who had tissue hypoperfusion. Conclusion: Results show that PCT is not a precise indicator of sepsis at the time of diagnosis. A correlation between PCT levels and hypoperfusion was observed. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.