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Impact of serum C-reactive protein measurements in the first 2 days on the 30-day mortality in hospitalized patients with severe community-acquired pneumonia: A cohort study.
MedLine Citation:
PMID:  23159134     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: The purpose of the study is to evaluate the impact of daily consecutive measurements of C-reactive protein (CRP) in the initial 2 days of hospitalization on the 30-day all-cause mortality in patients with severe community-acquired pneumonia (CAP). METHODS: We used 4 different thresholds of fractional decrease (FD) in CRP at the second day of admission (CRP2) of 25%, 30%, 40%, and 60%. In addition, we studied the association of each of these thresholds with the 30-day all-cause mortality. RESULTS: The mean age was 64 ± 20; males, 59%. The 30-day mortality rate was 18% (20/111). The mean serum CRP levels at the first day of all study group and CRP2 were 203 ± 98 vs 146 ± 92 mg/L, respectively, P = .05. The mean FD in CRP2 levels among the survivors was 33 %, whereas among the nonsurvivors, was 7%, P < .001. Multiple regression analysis revealed that FD less than 25% in CRP2 was associated with 30-day all-cause mortality, odds ratio of 3.07 (95% confidence interval, 2.84-5.03), P = .002, compared with those with FD more than 25% in CRP2. CONCLUSIONS: Fractional decrease less than 25% in CRP levels at the second day was significantly associated with 30-day all-cause mortality in hospitalized patients with severe CAP.
Authors:
Nseir William; Raymond Farah; Julnar Mograbi; Nicola Makhoul
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
Journal Detail:
Title:  Journal of critical care     Volume:  -     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Internal Medicine Department and Infectious Diseases Unit, Holy Family Hospital, Nazareth, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel. Electronic address: w.nseir@yahoo.com.
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