Abstract
Background: Among SCAP patients mortality is usually high, especially in those requiring invasive mechanical ventilation (IMV) or vasopressor support (VS).We aimed to assess CRP on admission and 8th day values association with mortality and adverse outcomes in SCAP patients requiring intensive care unit (ICU) admission.
Methods: 30 ICU patients with SCAP (CURB-65 class 3,4) were enrolled. Control group included 16 healthy volunteers. X-ray examination, CRP levels measurement were performed on admission and on day 8. The main endpoints were in-hospital outcomes (in-hospital mortality (IHM),duration of ICU stay (DICUS)), necessity of IMV and VS.
Results: CRP values correlated with CURB-65 score (r=0,8;p<0,05 and r=0,76;p<0,05 respectively) and were statistically different in CURB-65 class 3 and 4 patients (p<0,05).CRP levels were higher in non-survivors vs survivors [median] [311 vs 241mg/ml,p<0,05 respectively]on the 1st and 8th days [249 vs 89 mg/ml, p<0,05 respectively], revealed correlation with IHM (r=0,64; p<0,05 and r=0,6; p<0,05 respectively). Longer DICUS was associated with higher CRP values on admission (r=0,43; p<0,05). CRP on the 1st day correlated with necessity of VS and IMV (r=0,79; p<0,05 and r=0,63; p<0,05 respectively), their values appeared to be higher in patients requiring VS and IMV vs those who didn't need them [311 vs 244 mg/ml respectively, p<0,05]. Negative X-ray dynamics was associated with increased CRP levels on the 1st day (r=0,55; p<0,05).
Conclusions: Increased CRP values in SCAP patients requiring ICU admission are associated with disease severity, negative X-ray dynamics and could be used for identifying patients with high IHM risk, prediction of DICUS, necessity of VS and IMV.
- © 2011 ERS