Evaluación del valor de la proteína C reactiva y de la procalcitonina en la predicción de infección y mortalidad en los niños quemados
| Autor: | María Teresa Rosanova, Ana Buchovsky, Hugo Basílico, Soledad Martiren, Moira Taicz, Nidia Tramonti, Roberto Lede, Cecilia Signorelli |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
biology business.industry C-reactive protein Poison control medicine.disease Gastroenterology Procalcitonin Confidence interval Surgery Sepsis Internal medicine Predictive value of tests Pediatrics Perinatology and Child Health medicine biology.protein Pediatric burn business Prospective cohort study |
| Zdroj: | Archivos Argentinos de Pediatria. 113 |
| ISSN: | 0325-0075 |
| Popis: | 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: 3048%); 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. |
| Databáze: | OpenAIRE |
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