Elevated C-reactive protein levels at ICU discharge as a predictor of ICU outcome: a retrospective cohort study

ObjectiveWe investigated whether serum high-sensitivity C reactive protein (hs-CRP) levels measured in an emergency department (ED) are associated with inhospital mortality in patients with cardiovascular disease (CVD).DesignA retrospective cohort study.SettingED of a teaching hospital in Japan.Participants12 211 patients with CVD aged ≥18 years who presented to the ED by an ambulance between 1 February 2006 and 30 September 2014 were evaluated.Main outcome measuresInhospital mortality.Results1156 patients had died. The inhospital mortality increased significantly with the hs-CRP levels (<3.0 mg/L: 7.0%, 95% CI 6.4 to 7.6; 3.1–5.4 mg/L: 9.6%, 95% CI 7.9 to 11.3: 5.5–11.5 mg/L: 11.2%, 95% CI 9.4 to 13.0; 11.6–33.2 mg/L: 12.3%, 95% CI 10.5 to 14.1 and ≥33.3 mg/L: 19.9%, 95% CI 17.6 to 22.2). The age-adjusted and sex-adjusted HR for total mortality was increased significantly in the three ≥5.5 mg/L groups compared with the <3.0 mg/L group (5.5–11.5 mg/L: HR=1.32, 95% CI 1.09 to 1.60, p=0.005; 11.6–33.2 mg/L: HR=1.38, 95% CI 1.14 to 1.65, p=0.001 and ≥33.3 mg/L: HR=2.15, 95% CI 1.84 to 2.51, p<0.001). Similar findings were observed for the CVD subtypes of acute myocardial infarction, heart failure, cerebral infarction and intracerebral haemorrhage. This association remained unchanged even after adjustment for age, sex and white cell count and withstood Bonferroni adjustment for multiple testing. When the causes of death were divided into primary CVD and non-CVD deaths, the association between initial hs-CRP levels and mortality remained significant, but the influence of hs-CRP levels was greater in non-CVD deaths than CVD deaths. The percentage of non-CVD deaths increased with hs-CRP levels; among the patients with hs-CRP levels ≥33.3 mg/L, non-CVD deaths accounted for 37.5% of total deaths.ConclusionOur findings suggest that increased hs-CRP is a significant risk factor for inhospital mortality among patients with CVD in an ED. Particular attention should be given to our finding that non-CVD death is a major cause of death among patients with CVD with higher hs-CRP levels.

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The prognostic value of C-reactive protein and albumin in patients undergoing resection of colorectal liver metastases. A retrospective cohort study

HPB ◽

10.1016/j.hpb.2020.10.019 ◽

2020 ◽

Author(s):

Petter Frühling ◽

Katarina Hellberg ◽

Patric Ejder ◽

Cecilia Strömberg ◽

Jozef Urdzik ◽

...

Keyword(s):

Cohort Study ◽

Liver Metastases ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Prognostic Value ◽

Colorectal Liver Metastases ◽

C Reactive Protein ◽

Reactive Protein

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C-Reactive Protein at 24 Hours after Hospital Admission may have Relevant Prognostic Accuracy in Acute Pancreatitis: A Retrospective Cohort Study

GE Portuguese Journal of Gastroenterology ◽

10.1016/j.jpge.2015.03.002 ◽

2015 ◽

Vol 22 (5) ◽

pp. 198-203 ◽

Cited By ~ 4

Author(s):

Filipe S. Cardoso ◽

Leonel B. Ricardo ◽

Ana M. Oliveira ◽

David V. Horta ◽

Ana L. Papoila ◽

...

Keyword(s):

Acute Pancreatitis ◽

Cohort Study ◽

Hospital Admission ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

C Reactive Protein ◽

Reactive Protein ◽

Prognostic Accuracy

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Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study

10.21203/rs.3.rs-47545/v1 ◽

2020 ◽

Author(s):

Tao Zhou ◽

Nan Zheng ◽

Xiang Li ◽

Dongmei Zhu ◽

YI HAN

Keyword(s):

Cohort Study ◽

Critical Illness ◽

Retrospective Cohort Study ◽

Lymphocyte Count ◽

Inflammatory Markers ◽

Retrospective Cohort ◽

Apache Ii ◽

Apache Ii Score ◽

C Reactive Protein ◽

Reactive Protein

Abstract Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

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