Procalcitonin kinetics early after severe burn injury and its value in diagnosis of sepsis.

Abstract Purpose To investigate the clinical significance of procalcitonin (PCT) kinetics in the early stage post burn and the perioperative period, and to assess its diagnosis performance for sepsis in major burn patients. Methods This retrospective study on major burn patents (≥40% total body surface area) admitted from 2014 to 2019 was conducted in Southwest Hospital, Chongqing, China. A total of 321 patients were included. The kinetics of PCT was analyzed during the 1st week post burn, the perioperative period, and at the onset of clinical suspected sepsis. Results Serum PCT concentration rose immediately after burn injury. Factors associated with increased PCT level in the 1st week post-burn include greater burn area (>70% TBSA) and lower age (≤14 years). Correlations between PCT kinetics post burn and the risk of early development of sepsis and mortality were observed. At the onset of sepsis, serum PCT increased significantly compared to its basal line level in the 48 h before. The area under the receiver operating characteristics curve of PCT concentration and its kinetic changes was 0.788 and 0.826, respectively. PCT kinetics showed better accuracy than PCT concentration in discrimination of Gram-positive sepsis. The optimal diagnostic thresholds for PCT concentration and its kinetics were 1.41 ng/mL, and a 1.34-fold elevation compared to the baseline level. Conclusions PCT kinetics in the early stage post burn was a prognostic factor for sepsis and mortality among major burn patients. Serum PCT levels could be a diagnostic biomarker for sepsis in major burn patients.