Checking procalcitonin suitability for prognosis and antimicrobial therapy monitoring in burn patients

作     者：Luís Cabral Vera Afreixo Rita Meireles Miguel Vaz Catarina Chaves Marisa Caetano Luís Almeida JoséArtur Paiva 

作者机构：Department of Plastic Surgery and Burns UnitUnidade de QueimadosCoimbra University Hospital Centre(CHUC)Av.Bissaya Barreto s/n3000-075 CoimbraPortugal Autonomous Section of Health Sciences(SACS)University of AveiroAveiroPortugal CIDMA-Center for Research and Development in Mathematics and ApplicationsiBiMEDInstitute for BiomedicineUniversity of AveiroAveiroPortugal Clinical Pathology DepartmentCoimbra University Hospital Centre(CHUC)CoimbraPortugal Pharmacy DepartmentCoimbra University Hospital Centre(CHUC)CoimbraPortugal MedinUPDepartment of Pharmacology and TherapeuticsFaculty of MedicineUniversity of PortoPortoPortugal Department of Emergency and Intensive Care MedicineCentro Hospitalar Sao JoaoPortoPortugal Faculty of MedicineUniversity of PortoGrupo de Infeccao e SépsisPortoPortugal. 

出 版 物：《Burns & Trauma》 (烧伤与创伤（英文）)

年 卷 期：2018年第6卷第1期

页      面：39-48页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Portuguese funds through the Center for Research and Development in Mathematics and Applications (CIDMA) by the Portuguese Foundation for Science and Technology (Fundacao para a Ciencia e a Tecnologia (FCT)) [ID/MAT/04106/2013] 

主　　题：Burns Sepsis Procalcitonin Prognosis Antimicrobial stewardship 

摘      要：Background: Due to greater infection susceptibility, sepsis is the main cause of death in burn patients. Quick diagnosis and patient stratification, early and appropriated antimicrobial therapy, and focus control are crucial for patients’survival. On the other hand, superfluous extension of therapy is associated with adverse events and arousal of microbial resistance. The use of biomarkers, necessarily coupled with close clinical examination, may predict outcomes, stratifying patients who need more intensive care, and monitor the efficacy of antimicrobial therapy, allowing faster de-escalation or stop, reducing the development of resistance and possibly the financial burden, without increasing mortality. The aim of this work is to check the suitability of procalcitonin (PCT) to fulfill these goals in a large sample of septic burn patients. Methods: One hundred and one patients, with 15% or more of total body surface area (TBSA) burned, admitted from January 2011 to December 2014 at Coimbra Burns Unit (CBU), in Portugal were included in the sample. All patients had a diagnosis of sepsis, according to the American Burn Association (ABA) criteria. The sample was factored by survival (68 survivors and 33 non-survivors). The maximum value of PCT in each day was used for statistical analysis. Data were summarized by location measures (mean, median, minimum, maximum, quartiles) and dispersion measures (standard error and range measures). Statistical analysis was performed with SPSS?23.0 IBM? for Windows?. Results: There were statistically significant differences between PCT levels of patients from the survivor and non-survivor groups during the first and the last weeks of hospitalization as well as during the first week after sepsis suspicion, being slightly higher during this period. During the first 7 days of antimicrobial therapy, PCT was always higher in the non-survivor, still without reaching statistical significance, but when the analysis was extended till the 15th