Download PDF
CC BY-NC-ND 4.0 · Indian J Plast Surg 2021; 54(03): 308-313
DOI: 10.1055/s-0041-1734574
Original Article

Evaluation of Serum Levels of Procalcitonin and C-Reactive Protein as Prognostic Indicators in Burns

Aparna Sinha
1   Department of Plastic Surgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
,
Mukesh Kumar Sharma
2   Department of Burns, Plastic and Reconstructive Surgery, PGIMER and Dr. R. M. L. Hospital, New Delhi, India
,
Komal Tripathi
2   Department of Burns, Plastic and Reconstructive Surgery, PGIMER and Dr. R. M. L. Hospital, New Delhi, India
,
Nandini Duggal
3   Department of Microbiology, PGIMER and Dr. R. M. L. Hospital, New Delhi, India
,
Vinay Kumar Tiwari
4   Department of Burns, Plastic and Reconstructive Surgery, VMMC and Safdarjung Hospital, New Delhi, India
› Author Affiliations Funding Source None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background Burn is a leading cause of fatality in a developing country. C-reactive protein levels (CRP) and procalcitonin (PCT) can be prognostic indicators for the burn patients' mortality.

Aim To assess serial levels of serum PCT and serum CRP as prognostic indicators in burns.

Patient and Methods In patients admitted with burns, alternate-day serum PCT and CRP were measured from the time of admission until the time of discharge or until survival. The change in trends of CRP and PCT serum levels were studied, and it was then correlated with mortality among these burn patients.

Results The first-day value of serum PCT > 1772 pg/mL and serum CRP > 71 mg/mL or any value of serum PCT > 2163 pg/mL and of serum CRP > 90 mg/L indicate a poor prognosis in burns.

Conclusions The day-1 values of PCT and CRP were significantly higher in nonsurvivors than survivors in burns. The increasing trends of serum PCT and CRP levels are independent predictors of mortality in burns requiring prompt intervention. Rising PCT and CRP level denote poor prognosis in burns with an increased likelihood of death by 4.5 and 23.6 times, respectively.

Keywords

burns - blood - C-reactive protein (CRP) - procalcitonin (PCT) - mortality


Publication History

Article published online:
02 September 2021

© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Tobiasen J, Hiebert JM, Edlich RF. The abbreviated burn severity index. Ann Emerg Med 1982; 11 (05) 260-262
    CrossrefPubMedGoogle Scholar
  • 2 Bargues L, Chancerelle Y, Catineau J, Jault P, Carsin H. Evaluation of serum procalcitonin concentration in the ICU following severe burn. Burns 2007; 33 (07) 860-864
    CrossrefPubMedGoogle Scholar
  • 3 Neely AN, Fowler LA, Kagan RJ, Warden GD. Procalcitonin in pediatric burn patients: an early indicator of sepsis?. J Burn Care Rehabil 2004; 25 (01) 76-80
    CrossrefPubMedGoogle Scholar
  • 4 Li Q, Gong X. Clinical significance of the detection of procalcitonin and C-reactive protein in the intensive care unit. Exp Ther Med 2018; 15 (05) 4265-4270
    PubMedGoogle Scholar
  • 5 Meng FS, Su L, Tang YQ, Wen Q, Liu YS, Liu ZF. Serum procalcitonin at the time of admission to the ICU as a predictor of short-term mortality. Clin Biochem 2009; 42 (10-11) 1025-1031
    CrossrefPubMedGoogle Scholar
  • 6 Ryan CM, Schoenfeld DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med 1998; 338 (06) 362-366
    CrossrefPubMedGoogle Scholar
  • 7 Schneider HG, Lam QT. Procalcitonin for the clinical laboratory: a review. Pathology 2007; 39 (04) 383-390
    CrossrefPubMedGoogle Scholar
  • 8 Mann EA, Wood GL, Wade CE. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: a systematic review of the literature. Burns 2011; 37 (04) 549-558
    CrossrefPubMedGoogle Scholar
  • 9 Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret GY. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med 2006; 34 (07) 1996-2003
    CrossrefPubMedGoogle Scholar
  • 10 Ahuja RB, Bhattacharya S, Rai A. Changing trends of an endemic trauma. Burns 2009; 35 (05) 650-656
    CrossrefPubMedGoogle Scholar
  • 11 Ahuja RB, Bhattacharya S, Rai A. Changing trends of an endemic trauma. Burns 2009; 35 (05) 650-656
    CrossrefPubMedGoogle Scholar
  • 12 Sharma BR, Harish D, Singh VP, Bangar S. Septicemia as a cause of death in burns: an autopsy study. Burns 2006; 32 (05) 545-549
    CrossrefPubMedGoogle Scholar
  • 13 Kumar A, Roberts D, Wood KE. et al Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006; 34 (06) 1589-1596
    CrossrefPubMedGoogle Scholar
  • 14 Bone RC, Balk RA, Cerra FB. et al The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992; 101 (06) 1644-1655
    CrossrefPubMedGoogle Scholar
  • 15 Barati M, Alinejad F, Bahar MA. et al Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns 2008; 34 (06) 770-774
    CrossrefPubMedGoogle Scholar
  • 16 Piroglu DI, Tulgar S, Piroglu MD. et al Do early procalcitonin levels aid in predicting mortality in burn patients?. Int J Clin Exp Med 2016; 9 (03) 6497-6503
    Google Scholar
  • 17 Kim HS, Yang HT, Hur J. et al Procalcitonin levels within 48 hours after burn injury as a prognostic factor. Ann Clin Lab Sci 2012; 42 (01) 57-64
    PubMedGoogle Scholar
  • 18 von D Heimburg, Stieghorst W, Khorram-Sefat R, Pallua N. Procalcitonin–a sepsis parameter in severe burn injuries. Burns 1998; 24 (08) 745-750
    CrossrefPubMedGoogle Scholar
  • 19 Pruchniewski D, Pawlowski T, Morkowski J, Mackiewicz S. C-reactive protein in management of children’s burns. Ann Clin Res 1987; 19 (05) 334-338
    PubMedGoogle Scholar