%0 Journal Article
%T Use of procalcitonin as a biomarker for sepsis in moderate to major paediatric burns
%A Amber Young
%A Julie Davies
%A Karen Coy
%A Karen Marlow
%A Katrina Keating
%A Linda Hollén
%A Mamta Shah
%A Narges Dailami
%A Nick Dodds
%A Nicola Pullan
%A Ryan Hughes
%A Sian Falder
%J Trauma
%@ 1477-0350
%D 2019
%R 10.1177/1460408618760940
%X Accurate and early detection of sepsis poses a significant challenge in burn populations. Our objective was to assess whether procalcitonin is a marker of blood culture positive sepsis in moderate to severe paediatric burns. We analysed procalcitonin levels in 27 children admitted with burns of 15–65% total body surface area. Procalcitonin was measured at admission (baseline), 24 and 48？h post-admission and during periods of suspected sepsis (diagnosed against pre-defined criteria). Patients were categorised into controls with no episodes of suspected sepsis (n？=？10) and those with episodes of suspected sepsis (n？=？17). The latter were split into two groups based on blood culture results: culture positive (bacteraemia) and culture negative patients. Baseline procalcitonin levels increased with burn size (odds ratio (95% confidence interval): 1.15 (1.02–1.29)). Suspected sepsis patients had larger burns than controls (median 31 vs. 20%; p？=？0.003). Only 5/23 suspected sepsis episodes were blood culture positive. Procalcitonin levels were similar in culture positive and culture negative patients (p？=？0.43). Sensitivity for predicting positive blood culture was 100% (95% confidence interval: 47.8–100.0%) but specificity was only 22.2% (95% confidence interval: 6.4–47.6%). Area under the curve was poor at 0.62 (95% confidence interval: 0.33–0.90). There was no significant change in procalcitonin levels from baseline to septic episode in either group (positive: p？=？0.35; negative: p？=？0.95). We conclude that evidence for the use of procalcitonin to diagnose bacteraemia in this population is poor, with burn size playing a significant role implying a correlation with systemic inflammation rather than sepsis
%K Procalcitonin
%K sepsis
%K burn injury
%K children
%K C-reactive protein
%U https://journals.sagepub.com/doi/full/10.1177/1460408618760940