Assessment of C-reactive protein and procalcitonin levels to predict infection and mortality in burn children.

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.