UNLABELLED: C-reactive protein (CRP) and procalcitonin(PCT) levels may distinguish between a systemic inflammatory response and an infection in burn children. OBJECTIVES: To establish the operative capability of CRP and PCT to diagnose infections and mortality. METHODS: Burn patients admitted to the hospital with clinical suspicion of an infection were included. CRP and PCT were measured and their operative diagnostic capabilities were calculated. RESULTS: Forty-eight patients (p) were included.Their median age was 49 months old (r: 17-86).The median burned surface area was 40% (r: 30-48%); 28 p (58%) had type AB and type B burn wounds. Infection was confirmed in 32 p (66.7%);the most common infection was burn-related sepsis (24 p, 75%), followed by burn wound infection (6 p, 19%). Eight patients (17%) died.It was not possible to establish CRP sensitivity and specificity because it was high in all patients,regardless of mortality, survival or the presence of infection. In relation to infections, PCT had a 90.6% sensitivity (95% confidence interval [CI]:75.8-96.8%), a 18.8% specificity (95% CI: 6.6-43%),a 69% positive predictive value (PPV) and a 50%negative predictive value (NPV). In relation to 30-day mortality, sensitivity was 100% (95% CI:67.6-100%), specificity 15% (95% CI: 7.1-29.1%),PPV 19% (95% CI: 10-33.3%) and NPV 100%(95% CI: 61-100%). CONCLUSIONS: In pediatric burn patients, neither CRP nor PCT showed an adequate operative capability to detect an infection or a fatal outcome.
UNLABELLED: C-reactive protein (CRP) and procalcitonin(PCT) levels may distinguish between a systemic inflammatory response and an infection in burn children. OBJECTIVES: To establish the operative capability of CRP and PCT to diagnose infections and mortality. METHODS: Burn patients admitted to the hospital with clinical suspicion of an infection were included. CRP and PCT were measured and their operative diagnostic capabilities were calculated. RESULTS: Forty-eight patients (p) were included.Their median age was 49 months old (r: 17-86).The median burned surface area was 40% (r: 30-48%); 28 p (58%) had type AB and type B burn wounds. Infection was confirmed in 32 p (66.7%);the most common infection was burn-related sepsis (24 p, 75%), followed by burn wound infection (6 p, 19%). Eight patients (17%) died.It was not possible to establish CRP sensitivity and specificity because it was high in all patients,regardless of mortality, survival or the presence of infection. In relation to infections, PCT had a 90.6% sensitivity (95% confidence interval [CI]:75.8-96.8%), a 18.8% specificity (95% CI: 6.6-43%),a 69% positive predictive value (PPV) and a 50%negative predictive value (NPV). In relation to 30-day mortality, sensitivity was 100% (95% CI:67.6-100%), specificity 15% (95% CI: 7.1-29.1%),PPV 19% (95% CI: 10-33.3%) and NPV 100%(95% CI: 61-100%). CONCLUSIONS: In pediatric burn patients, neither CRP nor PCT showed an adequate operative capability to detect an infection or a fatal outcome.
Authors: Christopher M Horvat; Jamie Bell; Sajel Kantawala; Alicia K Au; Robert S B Clark; Joseph A Carcillo Journal: Clin Pediatr (Phila) Date: 2019-03-31 Impact factor: 1.168
Authors: Birte Weber; Ina Lackner; Christian Karl Braun; Miriam Kalbitz; Markus Huber-Lang; Jochen Pressmar Journal: Front Pediatr Date: 2021-03-16 Impact factor: 3.418