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C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia
Introduction: Community-acquired pneumonia (CAP) presents high mortality rates and high healthcare costs worldwide. C-reactive protein (CRP) has been widely used as a biomarker for the management of CAP. We evaluated the performance of CRP threshold values and ΔCRP as predictors of CAP survival and...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605077/ https://www.ncbi.nlm.nih.gov/pubmed/36294849 http://dx.doi.org/10.3390/jpm12101710 |
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author | Travlos, Apostolos Bakakos, Agamemnon Vlachos, Konstantinos F. Rovina, Nikoletta Koulouris, Nikolaos Bakakos, Petros |
author_facet | Travlos, Apostolos Bakakos, Agamemnon Vlachos, Konstantinos F. Rovina, Nikoletta Koulouris, Nikolaos Bakakos, Petros |
author_sort | Travlos, Apostolos |
collection | PubMed |
description | Introduction: Community-acquired pneumonia (CAP) presents high mortality rates and high healthcare costs worldwide. C-reactive protein (CRP) has been widely used as a biomarker for the management of CAP. We evaluated the performance of CRP threshold values and ΔCRP as predictors of CAP survival and length of hospital stay. Methods: A total of 173 adult patients with CAP were followed for up to 30 days. We measured serum CRP levels on days 1, 4, and 7 (D1, D4, and D7) of hospitalization, and their variations between different days were calculated (ΔCRP). A multivariate logistic regression model was created with CAP 30-day survival and length of hospital stay as dependent variables, and absolute CRP values and ΔCRP, age, sex, smoking habit (pack-years), pO2/FiO2 ratio on D1, WBC on D1, and CURB-65 score as independent variables. Results: A total of six patients with CAP died (30-day mortality 3.47%). No difference was found in CRP levels and ΔCRP between survivors and non-survivors. Using a cut-off level of 9 mg/dL, the AUC (95% CI) for the prediction of survival of CRP on D4 and D7 were 0.765 (0.538–0.992) and 0.784 (0.580–0.989), respectively. A correlation between CRP values on any day and length of hospital stay was found, with it being stronger for CRPD4 and CRPD7 (p < 0.0001 and p = 0.0024, respectively). A reduction of CRP > 50% from D1 to D4 was associated with 4.11 fewer days of hospitalization (p = 0.0308). Conclusions: CRP levels on D4 and D7, but not ΔCRP, could fairly predict CAP survival. A reduction of CRP > 50% by the fourth day of hospitalization could predict a shorter hospital stay. |
format | Online Article Text |
id | pubmed-9605077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96050772022-10-27 C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia Travlos, Apostolos Bakakos, Agamemnon Vlachos, Konstantinos F. Rovina, Nikoletta Koulouris, Nikolaos Bakakos, Petros J Pers Med Article Introduction: Community-acquired pneumonia (CAP) presents high mortality rates and high healthcare costs worldwide. C-reactive protein (CRP) has been widely used as a biomarker for the management of CAP. We evaluated the performance of CRP threshold values and ΔCRP as predictors of CAP survival and length of hospital stay. Methods: A total of 173 adult patients with CAP were followed for up to 30 days. We measured serum CRP levels on days 1, 4, and 7 (D1, D4, and D7) of hospitalization, and their variations between different days were calculated (ΔCRP). A multivariate logistic regression model was created with CAP 30-day survival and length of hospital stay as dependent variables, and absolute CRP values and ΔCRP, age, sex, smoking habit (pack-years), pO2/FiO2 ratio on D1, WBC on D1, and CURB-65 score as independent variables. Results: A total of six patients with CAP died (30-day mortality 3.47%). No difference was found in CRP levels and ΔCRP between survivors and non-survivors. Using a cut-off level of 9 mg/dL, the AUC (95% CI) for the prediction of survival of CRP on D4 and D7 were 0.765 (0.538–0.992) and 0.784 (0.580–0.989), respectively. A correlation between CRP values on any day and length of hospital stay was found, with it being stronger for CRPD4 and CRPD7 (p < 0.0001 and p = 0.0024, respectively). A reduction of CRP > 50% from D1 to D4 was associated with 4.11 fewer days of hospitalization (p = 0.0308). Conclusions: CRP levels on D4 and D7, but not ΔCRP, could fairly predict CAP survival. A reduction of CRP > 50% by the fourth day of hospitalization could predict a shorter hospital stay. MDPI 2022-10-13 /pmc/articles/PMC9605077/ /pubmed/36294849 http://dx.doi.org/10.3390/jpm12101710 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Travlos, Apostolos Bakakos, Agamemnon Vlachos, Konstantinos F. Rovina, Nikoletta Koulouris, Nikolaos Bakakos, Petros C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia |
title | C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia |
title_full | C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia |
title_fullStr | C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia |
title_full_unstemmed | C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia |
title_short | C-Reactive Protein as a Predictor of Survival and Length of Hospital Stay in Community-Acquired Pneumonia |
title_sort | c-reactive protein as a predictor of survival and length of hospital stay in community-acquired pneumonia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605077/ https://www.ncbi.nlm.nih.gov/pubmed/36294849 http://dx.doi.org/10.3390/jpm12101710 |
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