Publication Date |
2013 |
Personal Author |
Mann-Salinas, E. A.; Baun, M. M.; Meininger, J. C.; Murray, C. K.; Aden, J. K.; Wolf, S. E.; Wade, C. E. |
Page Count |
14 |
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 mEq/L, temperature less than 36 degrees Celsius, use of vasoactive medications, and glucose greater than 150 mg/dl. 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. |
Keywords |
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Source Agency |
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NTIS Subject Category |
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Corporate Authors |
Army Inst. of Surgical Research, Fort Sam Houston, TX. |
Supplemental Notes |
Published in the Journal of Burn Care & Research, v31 n1 p31-43, January/February 2013. |
Document Type |
Technical Report |
Title Note |
Journal article |
NTIS Issue Number |
201518 |
Contract Number |
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