Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia

BACKGROUND/AIMS: The purpose of this study was to evaluate the value of initial C-reactive protein (CRP) as a predictor of clinical outcome and to investigate whether follow-up CRP measurement is useful for the prediction of the clinical outcome of bloodstream infections in patients with liver cirrh...

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Autores principales: Ha, Young Eun, Kang, Cheol-In, Joo, Eun-Jeong, Joung, Mi-Kyong, Chung, Doo Ryeon, Peck, Kyong Ran, Lee, Nam Yong, Song, Jae-Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Internal Medicine 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110852/
https://www.ncbi.nlm.nih.gov/pubmed/21716910
http://dx.doi.org/10.3904/kjim.2011.26.2.195
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author Ha, Young Eun
Kang, Cheol-In
Joo, Eun-Jeong
Joung, Mi-Kyong
Chung, Doo Ryeon
Peck, Kyong Ran
Lee, Nam Yong
Song, Jae-Hoon
author_facet Ha, Young Eun
Kang, Cheol-In
Joo, Eun-Jeong
Joung, Mi-Kyong
Chung, Doo Ryeon
Peck, Kyong Ran
Lee, Nam Yong
Song, Jae-Hoon
author_sort Ha, Young Eun
collection PubMed
description BACKGROUND/AIMS: The purpose of this study was to evaluate the value of initial C-reactive protein (CRP) as a predictor of clinical outcome and to investigate whether follow-up CRP measurement is useful for the prediction of the clinical outcome of bloodstream infections in patients with liver cirrhosis (LC), whose CRP production in response to infection may be attenuated. METHODS: A retrospective, observational study including 202 LC patients with Escherichia coli or Klebsiella pneumoniae bacteremia was conducted to assess the usefulness of serial CRP measurements in predicting clinical outcome in LC patients. The CRP ratio was defined as the ratio of the follow-up CRP level to the initial CRP level. RESULTS: The overall 30-day mortality rate of the study population was 23.8% (48/202). In the multivariate analysis, advanced age (≥ 70 years), healthcare-associated or nosocomial infections, model for end-stage liver disease (MELD) score of ≥ 30, and initial body temperature of < 37℃ were significant factors associated with mortality (all p < 0.05). No association between initial CRP level and mortality was found. In a further analysis including 87 evaluable cases who had repeated CRP measurements at day 4 and/or 5, a CRP ratio of ≥ 0.7 was found to be a significant factor associated with mortality (odds ratio, 19.12; 95% confidence interval, 1.32 to 276.86; p = 0.043) after adjusting for other confounding variables. CONCLUSIONS: Initial CRP level did not predict mortality of sepsis in LC patients. However, serial CRP measurements during the first week of antimicrobial therapy may be useful as a prognostic factor for mortality in LC patients.
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spelling pubmed-31108522011-06-28 Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia Ha, Young Eun Kang, Cheol-In Joo, Eun-Jeong Joung, Mi-Kyong Chung, Doo Ryeon Peck, Kyong Ran Lee, Nam Yong Song, Jae-Hoon Korean J Intern Med Original Article BACKGROUND/AIMS: The purpose of this study was to evaluate the value of initial C-reactive protein (CRP) as a predictor of clinical outcome and to investigate whether follow-up CRP measurement is useful for the prediction of the clinical outcome of bloodstream infections in patients with liver cirrhosis (LC), whose CRP production in response to infection may be attenuated. METHODS: A retrospective, observational study including 202 LC patients with Escherichia coli or Klebsiella pneumoniae bacteremia was conducted to assess the usefulness of serial CRP measurements in predicting clinical outcome in LC patients. The CRP ratio was defined as the ratio of the follow-up CRP level to the initial CRP level. RESULTS: The overall 30-day mortality rate of the study population was 23.8% (48/202). In the multivariate analysis, advanced age (≥ 70 years), healthcare-associated or nosocomial infections, model for end-stage liver disease (MELD) score of ≥ 30, and initial body temperature of < 37℃ were significant factors associated with mortality (all p < 0.05). No association between initial CRP level and mortality was found. In a further analysis including 87 evaluable cases who had repeated CRP measurements at day 4 and/or 5, a CRP ratio of ≥ 0.7 was found to be a significant factor associated with mortality (odds ratio, 19.12; 95% confidence interval, 1.32 to 276.86; p = 0.043) after adjusting for other confounding variables. CONCLUSIONS: Initial CRP level did not predict mortality of sepsis in LC patients. However, serial CRP measurements during the first week of antimicrobial therapy may be useful as a prognostic factor for mortality in LC patients. The Korean Association of Internal Medicine 2011-06 2011-06-01 /pmc/articles/PMC3110852/ /pubmed/21716910 http://dx.doi.org/10.3904/kjim.2011.26.2.195 Text en Copyright © 2011 The Korean Association of Internal Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ha, Young Eun
Kang, Cheol-In
Joo, Eun-Jeong
Joung, Mi-Kyong
Chung, Doo Ryeon
Peck, Kyong Ran
Lee, Nam Yong
Song, Jae-Hoon
Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia
title Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia
title_full Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia
title_fullStr Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia
title_full_unstemmed Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia
title_short Usefulness of C-Reactive Protein for Evaluating Clinical Outcomes in Cirrhotic Patients with Bacteremia
title_sort usefulness of c-reactive protein for evaluating clinical outcomes in cirrhotic patients with bacteremia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110852/
https://www.ncbi.nlm.nih.gov/pubmed/21716910
http://dx.doi.org/10.3904/kjim.2011.26.2.195
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