Article
The role of Pancreatic Stone Protein as early marker for infection and mortality in burns
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Published: | January 18, 2017 |
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Background: In patients with major burns, early diagnosis of infection/sepsis is paramount as mortality increases by 7.6% for each hour delay of appropriate antimicrobial therapy. Pancreatic stone protein (PSP) has recently emerged as a promising diagnostic and prognostic marker in the clinical field. However, PSP time course and its predictive value regarding infection and mortality have not been studied in severely burned patients so far.
Methods: In a prospective cohort of burn patients we analyzed blood samples to elucidate diagnostic/prognostic accuracy of serum PSP levels over a 14 days time course. In addition, we investigated whether PSP levels were influenced by age and total body surface area (TBSA).
Results: Preliminary data of 26 burn victims (mean age: 48±20 years, median TBSA: 25% (IQR 21.7), median ABSI: 7 (IQR 3)) showed PSP levels not to be influenced by age and TBSA at admission to hospital. Receiver Operating Characteristic (ROC) curve demonstrated PSP to have significant predictive power at day 3 after trauma to delineate patients with infections from those with an uneventful course (AUC: 0.83, 95%-CI: 0.61-1.0). Non-survivors as opposed to survivors showed significantly higher PSP serum levels at admission. Currently, more samples are being analyzed and will be incorporated in the results for presentation.
Conclusion: Serum PSP levels were significantly associated with the presence of infection and mortality irrespective of the patients’ age and TBSA. In that way, PSP might serve as helpful biomarker for timely identification of patients in need of anti-infectious treatment. Likewise, PSP may serve as a predictive marker for fatal outcome leading to early ethical considerations.