scholarly journals A composite score combining procalcitonin, C-reactive protein and temperature has a high positive predictive value for the diagnosis of intensive care-acquired infections

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Laurent Robriquet ◽  
Caroline Séjourné ◽  
Eric Kipnis ◽  
Michele D’herbomez ◽  
François Fourrier
Keyword(s):  
Intensive Care ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Composite Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
High Positive Predictive Value

scholarly journals Development of an Algorithm for Surveillance of Ventilator-Associated Pneumonia With Electronic Data and Comparison of Algorithm Results With Clinician Diagnoses

2008 ◽  
Vol 29 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Michael Klompas ◽  
Ken Kleinman ◽  
Richard Platt
Keyword(s):  
Intensive Care ◽  
Positive Predictive Value ◽  
Intensive Care Units ◽  
Predictive Value ◽  
Ventilator Associated Pneumonia ◽  
Surgical Intensive Care ◽  
Electronic Data ◽  
Prospective Comparison ◽  
Control And Prevention ◽  
High Positive Predictive Value

Objective.Surveillance for ventilator-associated pneumonia (VAP) using standard Centers for Disease Control and Prevention (CDC) criteria is labor intensive and involves many subjective assessments. We sought to improve the efficiency and objectivity of VAP surveillance by adapting the CDC criteria to make them amenable to evaluation with electronic data.Design.Prospective comparison of the accuracy of VAP surveillance by use of an algorithm with responses to prospective queries made to intensive care physicians. CDC criteria for VAP were used as a reference standard to evaluate the algorithm and clinicians' reports.Setting.Three surgical intensive care units and 2 medical intensive care units at an academic hospital.Methods.A total of 459 consecutive patients who received mechanical ventilation for a total of 2,540 days underwent surveillance by both methods during consecutive 3-month periods. Electronic surveillance criteria were chosen to mirror the CDC definition. Quantitative thresholds were substituted for qualitative criteria. Purely subjective criteria were eliminated. Increases in ventilator-control settings were taken to indicate worsening oxygenation. Semiquantitative Gram stain of pulmonary secretion samples was used to assess whether there was sputum purulence.Results.The algorithm applied to electronic data detected 20 patients with possible VAP. All cases of VAP were confirmed in accordance with standard CDC criteria (100% positive predictive value). Prospective survey of clinicians detected 33 patients with possible VAP. Seventeen of the 33 possible cases were confirmed (52% positive predictive value). Overall, 21 cases of confirmed VAP were identified by either method. The algorithm identified 20 (95%) of 21 known cases, whereas the survey of clinicians identified 17 (81%) of 21 cases.Conclusions.Surveillance for VAP using electronic data is feasible and has high positive predictive value for cases that meet CDC criteria. Further validation of this method is warranted.

scholarly journals Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors

2021 ◽  
Vol 8 ◽  
Author(s):  
Matteo Vassallo ◽  
Celine Michelangeli ◽  
Roxane Fabre ◽  
Sabrina Manni ◽  
Pierre L. Genillier ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Cancer Patients ◽  
Negative Predictive Value ◽  
Solid Tumors ◽  
Predictive Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Documented Infection ◽  
Baseline Levels ◽  
Sensitive Marker

Objectives: The roles of procalcitonin (PCT) and C-reactive protein (CRP) in febrile cancer patients is currently unclear. Our aim was to assess these in febrile patients with solid tumors and to identify cut-off values for ruling out infection.Methods: We retrospectively evaluated patients with solid tumors admitted to hospital due to fever. They were divided into those with Fever with microbiologically documented infection (FMDI), Fever with clinically documented infection (FCDI) and Tumor-related fever (TRF). PCT and CRP levels were compared. Receiver-operating curves were plotted to define the best cut-off values for discriminating between infection-related and cancer-related fever.Results: Between January 2015 to November 2018, 131 patients were recorded (mean age 68 years, 67% male, 86% with metastasis). Patients with FMDI or FCDI had significantly higher baseline levels of PCT and lower CRP/PCT than those with TRF. A PCT cut-off value of 0.52 ng/mL for discriminating between infection and cancer-associated fever yielded 75% sensitivity, 55% specificity, 77% positive predictive value (PPV), and 52% negative predictive value (NPV). A CRP/PCT ratio with a cut-off value of 95 showed 56% sensitivity, 70% specificity, 79% NPV, and 44% PPV.Discussion: PCT is a sensitive marker of sepsis or localized infection in patients with solid tumors, but its specificity is poor. The CRP/PCT ratio improves specificity, thus providing a reliable means of ruling out infection for values above 95.

scholarly journals C-reactive protein, as a marker for predicting acute appendicitis and its severity in KVG medical college and hospital, Sullia

2021 ◽  
Vol 8 (10) ◽  
pp. 3002
Author(s):  
Abhirup H. Ramu ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Clinical Suspicion ◽  
C Reactive Protein ◽  
Common Procedure ◽  
Medical College ◽  
Reactive Protein

Background: Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high despite several techniques and investigations used to improve the diagnostic accuracy. This study emphasizes the value of C reactive protein (CRP) in three groups of patients operated for clinical suspicion of acute appendicitis with different finding at appendicectomy namely an un-inflamed appendix, uncomplicated acute appendicitis or complicated acute appendicitis.Methods: This prospective study was performed on 100 consecutive patients who were operated on for treatment of acute appendicitis in KVG medical college and hospital between 01 August 2019 to 01 February 2021. Clinically proven by a surgeon, patients underwent appendicectomy. Serum CRP results of all patients were determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Statistical analysis will be made using descriptive statistic and SPSS version 21 was used for analysis.Results: The percentage of negative laparotomies was 13% and surgeon ‘s clinical suspicion was true in 87%. Preoperative CRP values were false negative in 21 patients with appendicitis and false positive in 2 patients with normal appendix. The difference of true and false results between CRP tests and surgeon’s diagnosis was statistically significant (p=0.001). Present study revealed, sensitivity=76%, specificity=87.5%, positive predictive value=96% and negative predictive value=41%.Conclusions: Serum C reactive protein when elevated supports the surgeon’s clinical diagnosis of acute appendicitis. It can be used frequently to diagnosis the acute appendicitis, so that the complication rate and negative laparotomies can be avoided. 

scholarly journals Combination of Fibrinogen and High-sensitivity C-reactive Protein Measurements is Potential in Identification of Acute Coronary Syndrome

2015 ◽  
Vol 7 (1) ◽  
pp. 31
Author(s):  
Djanggan Sargowo ◽  
Ferry Sandra
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Glucose ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Troponin I ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Hs Crp

BACKGROUND: Acute myocardial infarction (AMI) is one of cardiovascular diseases with high morbidity and mortality rates. Novel biomarkers that can detect accurately acute coronary syndrome (ACS) at early stage, are necessary to improve current strategies and/or to identify subjects who are at risk. Fibrinogen and high-sensitivity C-reactive protein (hs-CRP) roles in inflammation process could be potential for ACS early detection. This study was conducted to evaluate measurements of fibrinogen and hs-CRP on ACS.METHODS: An analytic observational study with cross sectional approach was conducted on patients with Troponin I positive. After signing informed consent, anamnesis and complete blood count were conducted. Besides that, liver function, renal function, and blood glucose tests were conducted as well. Samples of selected subjects were quantified with enzyme-linked immunosorbent assay (ELISA) for Troponin I, fibrinogen and hs-CRP. Then statistical analyses were performed.RESULTS: There were 76 subjects in each ACS and non-ACS groups. ACS group showed significant higher levels of both fibrinogen and hs-CRP compared to Non-ACS group (p=0.000). Among evaluated risk factors, diabetes mellitus (DM) (p=0.003) and hypertension (p=0.000) were significantly higher in ACS group than in non-ACS group. Among evaluated clinical factors, blood glucose (p=0.001) and age (p=0.000) were significantly higher in ACS group than in non-ACS group. Combination of fibrinogen and hs-CRP measurements showed the highest sensitivity (75.00%), specificity (80.26%), accuracy (77.63%), positive predictive value (79.19%) and negative predictive value (76.25%).CONCLUSION: Since fibrinogen and hs-CRP were increased in ACS group and combination of fibrinogen and hs-CRP measurements showed the highest sensitivity, specificity, accuracy, positive predictive value and negative predictive value, we suggest that combination of fibrinogen and hs-CRP measurements could give added value to identify ACS.KEYWORDS: fibrinogen, hs-CRP, biomarker, ACS, acute coronary syndrome, atherosclerosis, inflammation

scholarly journals Maternal serum levels of C-reactive protein at early pregnancy to predict fetal growth restriction and preterm delivery: A prospective cohort study

2020 ◽  
Author(s):  
Roshan Nikbakht ◽  
Elham Karimi Moghadam ◽  
Zeinab Nasirkhani
Keyword(s):  
Cohort Study ◽  
Positive Predictive Value ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Predictive Value ◽  
Maternal Serum ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Serum Crp

Background: A considerable evidence suggests that maternal inflammation dysregulation may play as a risk factor for both maternal and neonatal outcomes. Objective: The study’s objectives were designed to evaluate the correlation between serum C-reactive protein (CRP) levels, as an inflammation factor, preterm delivery, and small for gestational age (SGA) births. Materials and Methods: This prospective cohort study was conducted on 120 singleton pregnant women with gestational age less than 20 wk. Maternal CRP serum concentration was measured before 20 wk gestation. Patients were followed-up until the delivery and final outcomes of pregnancy were recorded in terms of preterm delivery and SGA births. Results: Serum CRP levels in participants with normal fetuses and SGA births were 4.09 ± 1.35 mg/l and 6.04 ± 3.29 mg/l, respectively (p = 0.19), while in cases of preterm delivery, it was 9.63 ± 5.78 mg/l (p < 0.001). By using receiver operating characteristic (ROC) curve, serum CRP levels (cut-off point 5.27 mg/l, area 0.836) had acceptable diagnostic accuracy value in distinguishing preterm delivery (sensitivity (75%), specificity (86.1%), positive predictive value (37.5%), negative predictive value (96.87%), accuracy (85%)) and serum CRP levels (cut-off point 6.67 mg/l, area 0.673) in distinguishing SGA births (sensitivity (50%), specificity (91.2%), positive predictive value (23.07%), and negative predictive value (97.19%), and accuracy (89.16 %)). Conclusion: Higher maternal serum CRP levels measured early in pregnancy may associate with higher risk of preterm delivery and SGA. Key words: C-reactive protein, Small for gestational age, Preterm birth.

scholarly journals Predictive value of C-reactive protein for radiographic spinal progression in axial spondyloarthritis in dependence on genetic determinants of fibrin clot formation and fibrinolysis

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001751
Author(s):  
Berthold Hoppe ◽  
Christian Schwedler ◽  
Hildrun Haibel ◽  
Maryna Verba ◽  
Fabian Proft ◽  
...  
Keyword(s):  
Predictive Value ◽  
Axial Spondyloarthritis ◽  
Fibrin Clot ◽  
Clot Formation ◽  
Genetic Determinants ◽  
C Reactive Protein ◽  
Inception Cohort ◽  
Reactive Protein ◽  
A Subunit ◽  
Fibrin Clots

ObjectiveGenetic determinants of fibrin clot formation and fibrinolysis have an impact on local and systemic inflammatory response. The aim of the present study was to assess whether coagulation-related genotypes affect the predictive value of C-reactive protein (CRP) in regards of radiographic spinal progression in axial spondyloarthritis (axSpA).MethodsTwo hundred and eight patients with axSpA from the German Spondyloarthritis Inception Cohort were characterised for genotypes of α-fibrinogen, β-fibrinogen (FGB) and γ-fibrinogen, factor XIII A-subunit (F13A) and α2-antiplasmin (A2AP). The relation between CRP levels and radiographic spinal progression defined as worsening of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) by ≥2 points over 2 years was assessed in dependence on the respective genetic background in logistic regression analyses.ResultsOverall, CRP was associated with mSASSS progression ≥2 points: time-averaged CRP ≥10 mg/L, OR: 3.32, 95% CI 1.35 to 8.13. After stratification for coagulation-related genotypes, CRP was strongly associated with mSASSS progression in individuals predisposed to form loose, fibrinolysis-susceptible fibrin clots (FGB rs1800790GG, OR: 6.86, 95% CI 2.08 to 22.6; A2AP 6Trp, OR: 5.86, 95% CI 1.63 to 21.0; F13A 34Leu, OR: 8.72, 95% CI 1.69 to 45.1), while in genotypes predisposing to stable fibrin clots, the association was absent or weak (FGB rs1800790A, OR: 0.83, 95% CI 0.14 to 4.84; A2AP 6Arg/Arg, OR: 1.47, 95% CI 0.35 to 6.19; F13A 34Val/Val, OR: 1.72, 95% CI 0.52 to 5.71).ConclusionsElevated CRP levels seem to be clearly associated with radiographic spinal progression only if patients are predisposed for loose fibrin clots with high susceptibility to fibrinolysis.

Predictive value of C-reactive protein at different cutoff levels in acute appendicitis

2005 ◽  
Vol 23 (4) ◽  
pp. 449-453 ◽  
Author(s):  
Han-Ping Wu ◽  
Ching-Yuang Lin ◽  
Chin-Fu Chang ◽  
Yu-Jun Chang ◽  
Chin-Yi Huang
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cutoff Levels

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients

2021 ◽  
Vol 27 (2) ◽  
pp. 212
Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti
Keyword(s):  
Acute Leukemia ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Negative Likelihood Ratio ◽  
Receiver Operating Curve ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

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