scholarly journals C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit

2012 ◽  
Vol 7 ◽  
Author(s):  
Özkan Devran ◽  
Zuhal Karakurt ◽  
Nalan Adıgüzel ◽  
Gökay Güngör ◽  
Özlem Yazıcıoğlu Moçin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Mortality Rate ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Icu Patients ◽  
Predictors Of Mortality ◽  
Reactive Protein ◽  
Chest Disease

Background: Severe sepsis is a primary cause of morbidity and mortality in the intensive care unit (ICU). Numerous biomarkers have been assessed to predict outcome and CRP is widely used. However, the relevance for mortality risk of the CRP level and the day when it is measured have not been well studied. We aimed to assess whether initial and/or third dayCRP values are as good predictors of mortality in ICU patients with severe sepsis as other well-known complex predictors of mortality, i.e., SOFA scores. Methods: An observational cohort study was performed in a 20-bed respiratory ICU in a chest disease center. Patients with severe sepsis due to respiratory disease were enrolled in the study. SOFA scores, CRP values on admission and on the third day of hospital stay, and mortality rate were recorded. ROC curves for SOFA scores and CRP values were calculated. Results: The study included 314 ICU patients with sepsis admitted between January 2009 and March 2010. The mortality rate was 14.2% (n = 45). The area under the curve (AUC) for CRP values and SOFA scores on admission and on the 3rd day in ICU were calculated as 0.57 (CI: 0.48-0.66); 0.72 (CI: 0.63-0.80); 0.72 (CI: 0.64-0.81); and 0.76 (CI: 0.67-0.86), respectively. Sepsis due to nosocomial infection, a CRP value > 100 mg/L and higher SOFA scores on 3rd day, were found to be risk factors for mortality (odds ratio [OR]: 3.76, confidence interval [CI]: 1.68-8.40, p < 0.001, OR: 2.70, CI: 1.41-2.01, p < 0.013, and OR: 1.68, CI: 1.41-2.01, p < 0.0001, respectively). Conclusions: The risk of sepsis related mortality appears to be increased when the 3rd day CRP value is greater than 100 mg/dL. Thus, CRP appears to be as valuable a predictor of mortality as the SOFA score.

Innovative haematological parameters for early diagnosis of sepsis in adult patients admitted in intensive care unit

2017 ◽  
Vol 71 (4) ◽  
pp. 330-335 ◽  
Author(s):  
Sabrina Buoro ◽  
Barbara Manenti ◽  
Michela Seghezzi ◽  
Paola Dominoni ◽  
Tiziano Barbui ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Diagnosis ◽  
Area Under The Curve ◽  
Clinical Information ◽  
Operating Characteristics ◽  
Early Management ◽  
Reactive Protein ◽  
Icu Stay ◽  
Immature Platelet Fraction

AimsThis study was aimed to investigate the role of erythrocyte, platelet and reticulocyte (RET) parameters, measured by new haematological analyser Sysmex XN and C reactive protein (CRP), for early diagnosis of sepsis during intensive care unit (ICU) stay.MethodsThe study population consisted of 62 ICU patients, 21 of whom developed sepsis during ICU stay and 41 who did not. The performance for early diagnosing of sepsis was calculated as area under the curve (AUC) of receiver operating characteristics curves analysis.ResultsCompared with CRP (AUC 0.81), immature platelet fraction (IPF) (AUC 0.82) showed comparable efficiency for identifying the onset of sepsis. The association with the risk of developing sepsis during ICU stay was also assessed. One day before the onset of sepsis, a decreased of RET% was significantly associated with the risk of developing sepsis (OR=0.35, 95% CI 0.14 to 0.87), whereas an increased of IPF absolute value (IPF#) was significantly associated with the risk of developing sepsis (OR=1.13, 95% CI 1.03 to 1.24) 2 days before the onset of sepsis. The value of CRP was not predictive of sepsis at either time points.ConclusionsIPF# and RET% may provide valuable clinical information for predicting the risk of developing sepsis, thus allowing early management of patients before the onset of clinically evident systemic infections.

scholarly journals Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 402
Author(s):  
Renée Blaauw ◽  
Daan G. Nel ◽  
Gunter K. Schleicher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Area Under The Curve ◽  
Threshold Value ◽  
High Plasma ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Proxy Indicators

Low and high plasma glutamine levels are associated with increased mortality. This study aimed to measure glutamine levels in critically ill patients admitted to the intensive care unit (ICU), correlate the glutamine values with clinical outcomes, and identify proxy indicators of abnormal glutamine levels. Patients were enrolled from three ICUs in South Africa, provided they met the inclusion criteria. Clinical and biochemical data were collected. Plasma glutamine was categorized as low (<420 µmol/L), normal (420–700 µmol/L), or high (>700 µmol/L). Three hundred and thirty patients (median age 46.8 years, 56.4% male) were enrolled (median APACHE II score) 18.0 and SOFA) score 7.0). On admission, 58.5% had low (median 299.5 µmol/L) and 14.2% high (median 898.9 µmol/L) plasma glutamine levels. Patients with a diagnosis of polytrauma and sepsis on ICU admission presented with the lowest, and those with liver failure had the highest glutamine levels. Admission low plasma glutamine was associated with higher APACHE II scores (p = 0.003), SOFA scores (p = 0.003), C-reactive protein (CRP) values (p < 0.001), serum urea (p = 0.008), and serum creatinine (p = 0.023) and lower serum albumin (p < 0.001). Low plasma glutamine was also associated with requiring mechanical ventilation and receiving nutritional support. However, it was not significantly associated with length of stay or mortality. ROC curve analysis revealed a CRP threshold value of 87.9 mg/L to be indicative of low plasma glutamine levels (area under the curve (AUC) 0.7, p < 0.001). Fifty-nine percent of ICU patients had low plasma glutamine on admission, with significant differences found between diagnostic groupings. Markers of infection and disease severity were significant indicators of low plasma glutamine.

scholarly journals Survival and Predictors of Mortality Among Patients Admitted to Intensive Care Unit in Southern Ethiopia: A Multi-center Retrospective Cohort Study

2020 ◽  
Author(s):  
semagn Mekonnen Abate ◽  
Sofia Assen ◽  
Mengistu Yinges ◽  
Bivash Basu
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Mortality Rate ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Southern Ethiopia ◽  
Icu Mortality ◽  
Predictors Of Mortality

Abstract Background: The burden of life-threatening conditions requiring intensive care unit has grown substantially in low-income countries related to an emerging pandemic, urbanization, and hospital expansion. The rate of ICU mortality is varied from region to region in Ethiopia. However, body of evidence on ICU mortality and its predictors is uncertain. This study was designed to investigate the pattern of disease and predictors of mortality in Southern Ethiopia.Methods: After obtaining Ethical clearance from institutional Review Board (IRB), a multi-center retrospective Cohort study was conducted among three teaching referral hospital ICUs of southern Ethiopia from June, 2018 to May, 2020. Five hundred and seventeen Adult ICU patients were selected. Data were entered in Statistical Package for Social Sciences version 22 and STATA version 16 for analysis. Descriptive statistics were run to see the overall distribution of the variables. Chi square test and odds ratio were determine to identify the association between independent and dependent variables. Multivariate analysis was conducted to control possible confounders and identify independent predictors of ICU mortality.Results: The mean (± SD) of the patients admitted in ICU was 34.25(±5.25). The overall ICU mortality rate was 46.8%. The study identified different independent predictors of mortality. Patients with cardiac arrest were approximately 12 times more likely to die as compared to who didn’t, AOR=11.9 (95% CI:6.1 to 23.2).Conclusion: The overall mortality rate in ICU was very high as compared to other studies in Ethiopia as well as globally which entails a rigorous activity from different stakeholders.

scholarly journals C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit

2012 ◽  
Vol 7 (1) ◽  
pp. 47 ◽  
Author(s):  
Özkan Devran ◽  
Zuhal Karakurt ◽  
Nalan Adıgüzel ◽  
Gökay Güngör ◽  
Özlem Moçin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Severe Sepsis ◽  
Intensive Care ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals PROGNOSTIC VALUE OF PRO-ADRENOMEDULLIN, PROCALCITONIN AND C-REACTIVE PROTEIN IN COMMUNITY ACQUIRED PNEUMONIA

2017 ◽  
Vol 5 ◽  
pp. 978-982 ◽  
Author(s):  
Darina Miteva ◽  
Yordan Radkov ◽  
Lilyia Ivanova ◽  
Trifon Chervenkov ◽  
Vanya Kostadinova
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Mortality Rate ◽  
Prognostic Value ◽  
Community Acquired Pneumonia ◽  
Moderate Correlation ◽  
C Reactive Protein ◽  
Hospital Unit ◽  
Reactive Protein

Introduction: Various biomarkers are used to evaluate the severity and prognosis of community acquired pneumonia (CAP).Objectives: To study and compare the prognostic value of MR-proADM, РСТ and CRP in predicting the severity and outcome of CAP.Methods: A prospective cohort study of 92 patients hospitalized with CAP in the Clinic of Pneumology and Phthisiatrics of MHAT “Saint Marina”–Varna in 2015 was conducted. The biomarkers were measured on admission. Midregional pro-adrenomedullin (MR-proADM) and procalcitonin (РСТ) were measured by standard ELISA, and C-reactive protein (CRP) was determined by latex-enhanced immunoturbidimetric assay. CAP severity was assessed by CURB-65.Results: Patients were on average 59.2±16.8 years of age; 68.5% of them were male. The in-hospital mortality rate was 7.6%. The three biomarkers MR-proADM, РСТ and CRP were significantly higher in non-survivors compared to survivors (0.918±0.045 ng/ml vs. 0.397±0.269ng/ml, р<0.001; 2.14±0.60ng/ml vs. 1.12±0.68ng/ml, р<0.001 and 215.12±96.39 mg/L vs.175.74±221.5mg/L, p<0.05 respectively). In patients who needed intensive care, the biomarkers were also significantly higher than those in patients treated in the general hospital unit (0.509±0.336ng/ml vs. 0.414±0.28ng/ml, р<0.05; 1.92±0.76 ng/ml vs. 1.15±0.70ng/ml, p<0.05 and 221.98±100.34 mg/L vs. 165.31±122.84 mg/L, p<0.05 resp.). MR-proADM and РСТ showed a moderate correlation with the CURB-65 (r=0.33, p<0.01 and r=0.30, p<0.05 respectively). CRP did not correlate with the CURB-65 (r=0.10, p>0.05).Conclusion: MR-proADM, РСТ and CRP were significantly higher in non-survivors and in patients treated in the intensive care unit. MR-proADM and РСТ showed a moderate correlation with the CURB-65, while the correlation coefficient for MR-proADM was higher. CRP did not correlate with the CURB-65.

scholarly journals Two variants of the Nutritional Risk in the Critically Ill Score as predictors of mortality in Intensive Care Unit patients at a Brazilian University Hospital

2020 ◽  
Vol 33 ◽  
Author(s):  
Amanda Forte dos Santos SILVA ◽  
Audrey Machado dos REIS ◽  
Julia MARCHETTI ◽  
Oellen Stuani FRANZOSI ◽  
Thais STEEMBURGO
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Interleukin 6 ◽  
Characteristic Curve ◽  
University Hospital ◽  
Nutritional Risk ◽  
C Reactive Protein ◽  
Predictors Of Mortality ◽  
Reactive Protein

ABSTRACT Objective To evaluate the agreement between the modified version of the Nutritional Risk in the Critically Ill Score (without Interleukin-6) and a variant composed of C-Reactive Protein as well as its capacity to predict mortality. Methods A prospective cohort study was carried out with 315 patients in an Intensive Care Unit of a university hospital from October 2017 to April 2018. The agreement between the instruments was evaluated using the Kappa test. The predictive capacity for estimating mortality was assessed with the Receiver Operating Characteristic curve. Results The critical patients involved in the study had a mean age of 60.8±16.3 years and 53.5% were female. Most patients had C-Reactive Protein levels ?10mg/dL (n=263, 83.5%) and their admission in the Intensive Care Unit was medical (n=219, 69.5%). The prevalence of mortality was observed in 41.0% of the evaluated patients. The proportions at high nutritional risk according to Nutritional Risk in the Critically Ill without Interleukin-6 and with C-Reactive Protein were 57.5% and 55.6%, respectively. The tools showed strong and significant agreement(Kappa=0.935; p=0.020) and satisfactory performances in predicting mortality (area under the curve 0.695 [0.636-0.754] and 0.699 [0.640-0.758]). Conclusion Both versions of the Nutritional Risk in the Critically Ill tool show a satisfactory agreement and performance as predictors of mortality in critically ill patients. Further analysis of this variant and the association between nutrition adequacy and mortality is needed.

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