Predictive values of presepsin and c-reactive protein on prognosis in severe burns

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.