Valuable prognostic indicators for severe burn sepsis with inhalation lesion: age, platelet count, and procalcitonin.

Background: Severe burn sepsis can lead to high mortality. We explored the valuable prognostic indicators for severe burn sepsis with inhalation lesion.

Methods: Thirty-eight severe burn patients with sepsis who were admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2017 were retrospectively analyzed. Among them, 22 patients were assigned to the death group and 16 patients to the survival group. Their general information, vital signs, and blood index including serum procalcitonin (PCT) and C-reactive protein (CRP) levels at admission, diagnosis of sepsis, and 1-week post-diagnosis of sepsis were compared.

Results: Patients in the death group were older and had lower platelet count (PLT) at diagnosis of sepsis and 1-week post-diagnosis as well as higher PCT level at 1-week post-diagnosis than patients in the survival group (all p  < 0.05). According to receiver operating characteristic (ROC) curves, the above four indicators could be used to predict the prognosis, and the area under the curve (AUC) of PLT at diagnosis and 1-week post-diagnosis was larger (0.888 and 0.911), and PLT at diagnosis had the highest sensitivity and specificity (0.842 and 0.937). In addition, these patients were divided into two groups by the optimal cutoff age of 38 years. According to multivariate logistic regression analysis and COX regression analysis, only age group and PLT at diagnosis were statistically significant (all p  < 0.05). The risk of death in the older group was 28 times higher than that in the younger group, and the risk of death increased by 3% for each unit reduction in PLT at diagnosis. Moreover, age group was an independent factor affecting the patients' survival ( β  = - 1.370, p  = 0.026). Considering the survival time after sepsis, the mortality risk was lower for patients in the older group than for patients in the younger group (hazard ratio (HR) = 0.254, 95% confidence interval (CI) 0.076-0.851).

Conclusion: Age, PLT at diagnosis of sepsis, and 1-week post-diagnosis as well as PCT level at 1-week post-diagnosis are indicators for the evaluation of prognosis of severe burn sepsis with inhalation lesion. Among them, PLT at diagnosis has the greatest prognostic value. In addition, age can predict the patients' mortality and survival time after sepsis.