Do early procalcitonine levels aid in predicting mortality in burn patients?

Abstract

Aim: Burn patients in intensive care units (ICU) are at high risk of mortality. Our aim in this stuy is to evaluate the use of first 48 hour procalcitonin level (PCT), C-reactive protein (CRP) and APACHE II score for the prediction of mortality in burn patients admitted to ICU. Material and method: Files of patients with burns admitted to a tertiary centre's burn unit were retrospectively analysed and those with procalcitonin and C-reactive protein level measurements and APACHE II scores within first 48 hours of admittance were included in this study. Patients with comorbidities that would effect PCT and CRP levels such as chronic renal or liver failure were excluded from the study. Patients PCT, CRP and APACHE II scores were compared with the outcome of patients. Results: Seventy patients were included in this study. While CRP levels were lower in patients that were deceased, PCT levels were significantly higher in these patients. In patients with APACHE II score > 20 and PCT > 2 ng/ml, mortality was statistically very significantly higher compared with other patients. Logistical regression analysis showed that high PCT levels and APACHE II scores were important at predicting mortality in these patients. Conclusion: High PCT levels within 48 hours of burns is a predictor of mortality in these patients. Additional studies are required to correctly determine the cut-off value. A modified scoring system including APACHE II and PCT may be useful for better predicting mortality, although larger multi-centered studies are required.