Accession Number:

ADA615150

Title:

Novel Predictors of Sepsis Outperform the American Burn Association Sepsis Criteria in the Burn Intensive Care Unit Patient

Descriptive Note:

Journal article

Corporate Author:

ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX

Report Date:

2013-01-01

Pagination or Media Count:

14.0

Abstract:

The purpose of this study was to determine whether systemic inflammatory response syndrome SIRS and American Burn Association ABA criteria predict sepsis in the burn patient and develop a model representing the best combination of novel clinical sepsis predictors. A retrospective, case-controlled, within-patient comparison of burn patients admitted to a single intensive care unit from January 2005 to September 2010 was made. Blood culture results were paired with documented sepsis positive-sick, negative-sick collectively defined as sick, and negative-not sick. Data for all predictors were collected for the 72 hours before blood culture. Variables were evaluated using regression and area under the curve AUC analyses. Fifty-nine subjects represented 177 culture periods. SIRS criteria were not discriminative 98 of the subjects met criteria. ABA sepsis criteria were different on the day before P .004. The six best-fit variables identified for the model included heart rate greater than 130 beats per min, mean arterial pressure less than 60 mm Hg, base deficit less than 6 mEqL, temperature less than 36 degrees Celsius, use of vasoactive medications, and glucose greater than 150 mgdl. The model was significant in predicting positive-sick and sick, with an AUC of 0.775 P less than .001 and 0.714 P less than .001, respectively comparatively, the ABA criteria AUC was 0.619 P .028 and 0.597 P .035, respectively. Usefulness of the ABA criteria to predict sepsis is limited to the day before blood culture is obtained. A significant contribution of this research is the identification of six novel sepsis predictors for the burn patient.

Subject Categories:

  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE