Does C-reactive protein independently predict mortality in adult community-acquired bacteremia patients with known sepsis severity?

被引:22
作者
Gradel, Kim O. [1 ]
Jensen, Thoger G. [2 ]
Kolmos, Hans J. [2 ]
Pedersen, Court [3 ]
Vinholt, Pernille J. [4 ]
Lassen, Annmarie T. [5 ]
机构
[1] Odense Univ Hosp, Res Unit Clin Epidemiol, Ctr Natl Clin Databases, DK-5000 Odense C, Denmark
[2] Odense Univ Hosp, Dept Clin Microbiol, DK-5000 Odense C, Denmark
[3] Odense Univ Hosp, Dept Infect Dis, DK-5000 Odense C, Denmark
[4] Odense Univ Hosp, Dept Clin Biochem & Pharmacol, DK-5000 Odense C, Denmark
[5] Odense Univ Hosp, Dept Emergency Med, DK-5000 Odense C, Denmark
关键词
C-reactive protein; sepsis severity; adults; community acquired bacteremia; short-term mortality; PROGNOSTIC MARKER; PROCALCITONIN; INFECTION; INFLAMMATION; CARE;
D O I
10.1111/apm.12040
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
071005 [微生物学]; 100108 [医学免疫学];
摘要
We evaluated whether sepsis severity and C-reactive protein (CRP) level on admission prognostically corroborated or annulled each other in adult patients with incident community-acquired bacteremia (Funen, Denmark, 2000-2008). We used logistic regression and area under the receiver operating characteristic curve (AUC) to evaluate 30-day mortality in four models: (i) age, gender, comorbidity, bacteria, and ward. (ii) Model 1 and sepsis severity. (iii) Model 1 and CRP. (iv) Model 1, sepsis severity, and CRP. Altogether, 416 of 1999 patients died within 30days. CRP independently predicted 30-day mortality [Model 4, odds ratio (95% CIs) for 100mg/L: 1.16 (1.06-1.27)], but it did not contribute to the AUC (Model 2 vs Model 4: p=0.31). In the 963 non-severe sepsis patients, CRP independently predicted 30-day mortality [Model 4: 1.42 (1.20-1.69)] and it increased the AUC (Model 2 vs Model 4: p=0.06), thus CRP contributed as much as sepsis severity to prognosis.
引用
收藏
页码:835 / 842
页数:8
相关论文
共 31 条
[1]
Systematic reviews in health care - Systematic reviews of evaluations of prognostic variables [J].
Altman, DG .
BMJ-BRITISH MEDICAL JOURNAL, 2001, 323 (7306) :224-228
[2]
AMERICAN-COLLEGE OF CHEST PHYSICIANS SOCIETY OF CRITICAL CARE MEDICINE CONSENSUS CONFERENCE - DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ ;
ABRAMS, JH ;
BERNARD, GR ;
BIONDI, JW ;
CALVIN, JE ;
DEMLING, R ;
FAHEY, PJ ;
FISHER, CJ ;
FRANKLIN, C ;
GORELICK, KJ ;
KELLEY, MA ;
MAKI, DG ;
MARSHALL, JC ;
MERRILL, WW ;
PRIBBLE, JP ;
RACKOW, EC ;
RODELL, TC ;
SHEAGREN, JN ;
SILVER, M ;
SPRUNG, CL ;
STRAUBE, RC ;
TOBIN, MJ ;
TRENHOLME, GM ;
WAGNER, DP ;
WEBB, CD ;
WHERRY, JC ;
WIEDEMANN, HP ;
WORTEL, CH .
CRITICAL CARE MEDICINE, 1992, 20 (06) :864-874
[3]
Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction [J].
Castelli, GP ;
Pognani, C ;
Meisner, M ;
Stuani, A ;
Bellomi, D ;
Sgarbi, L .
CRITICAL CARE, 2004, 8 (04) :R234-R242
[4]
A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[5]
Danmarks Statistik, POP STAT
[6]
Baseline C-reactive protein level as a predictor of mortality in bacteraemia patients: a population-based cohort study [J].
Gradel, K. O. ;
Thomsen, R. W. ;
Lundbye-Christensen, S. ;
Nielsen, H. ;
Schonheyder, H. C. .
CLINICAL MICROBIOLOGY AND INFECTION, 2011, 17 (04) :627-632
[7]
Conducting pharmacoepidemiologic research in Denmark [J].
Hallas, J .
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2001, 10 (07) :619-623
[8]
Harrell FE., 2001, Regression Modeling Strategies: with Applications to Linear Models, Logistic Regression, and Survival Analysis, V608, DOI DOI 10.2147/
[9]
Hosmer DW., 2000, Applied logistic regression, DOI DOI 10.1002/0471722146.CH4
[10]
Proof of principle: The predisposition, infection, response, organ failure sepsis staging system [J].
Howell, Michael D. ;
Talmor, Daniel ;
Schuetz, Philipp ;
Hunziker, Sabina ;
Jones, Alan E. ;
Shapiro, Nathan I. .
CRITICAL CARE MEDICINE, 2011, 39 (02) :322-327