PREDICTIVE VALUES OF PRESEPSIN AND C-REACTIVE PROTEIN ON PROGNOSIS IN SEVERE BURNS
BOGDAN NITESCU 1,2, BOGDAN PAVEL 2,3*, IRINA ANDRA TACHE 4, IOANA ANASTASIA
POP 2, COSMIN ION BALAN 1,5, STEFAN SORIN ARAMA 6,8, SEBASTIAN ISAC 3, ADRIAN
STREINU-CERCEL 7,8, TALAPAN DANIELA 7,8, PITIGOI DANIELA 7,8, VICTORIA ARAMA 7,8
1“Carol Davila” University of Medicine and Pharmacy, Doctoral School, Bucharest, Romania
2Clinical Emergency Hospital of Plastic, Reconstructive Surgery and Burns, Bucharest, Romania
3“Carol Davila” University of Medicine and Pharmacy, Department of Functional Sciences, Bucharest, Romania
4University Politehnica of Bucharest, Department of Automatic Control and Systems Engineering, Romania
5“Prof. CC Iliescu” Emergency Institute for Cardiovascular Diseases, 1st Department of Cardiovascular Anaesthesiology and Intensive Care, Bucharest, Romania
6“Carol Davila” University of Medicine and Pharmacy, Department - Dental Medicine II, Bucharest, Romania 7“Carol Davila” University of Medicine and Pharmacy, Department of Infectious Disease, Epidemiology, Microbiology,
Parasitology, Virusology, Diabetes and Endocrinology, Bucharest, Romania 8“Matei Balș” National Institute of Infectious Disease, Bucharest, Romania
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Burn patients are at risk of sepsis, hemodynamic instability, and high mortality due to burn-induced inflammation. Inflammatory biomarkers, such as presepsin (PSP) and C-reactive protein (CRP), predict these outcomes. Low albumin, blood iron, and platelet levels indicate sepsis in severe burns. A prospective study with 121 patients and 355 blood samples examined these biomarkers and their correlation with vasopressor use.The CRP cut-off for sepsis prediction was >194 mg/L (AUC: 0.631). Biomarkers complement clinical criteria and wound cultures but do not diagnose sepsis. CRP >180 mg/L and PSP >868 pg/mL indicated vasopressor use (AUC: 0.63 and 0.68). Patients with CRP <180 mg/L and PSP <868 pg/mL had low hemodynamic instability risk. Univariate and multivariate analyses identified PSP, platelet count, and the Abbreviated Burn Severity Index (ABSI) as mortality predictors, excluding CRP. PSP >867 pg/mL (AUC: 0.685) predicted disease. Timely intervention based on predictive values aids antibiotic treatment selection in burn patients with multi-drug resistance. In summary, PSP, CRP, and other biomarkers predict sepsis, hemodynamic instability, and mortality in burn patients. Combining biomarkers with clinical criteria improves decision-making. Predictive values guide timely interventions, addressing infections and selecting antibiotics. These findings have significant implications for managing burn patients.
