Sequential C-reactive protein: a cheap and a valuable biomarker in patients with sepsis
DOI:
https://doi.org/10.18203/2320-6012.ijrms20191687Keywords:
Biomarker, C-reactive protein, SepsisAbstract
Background: C-reactive protein (CRP) is a valuable biomarker of sepsis. Levels of CRP increase very rapidly in response to infection, and decrease just as rapidly with the resolution of the condition. The aim of the research was to study, C-reactive protein levels in patients of sepsis and to study the pattern of CRP levels in patients of Sepsis with hypertension, diabetes, smokers and alcoholics.
Methods: This prospective observational cohort study was conducted from December 2016 to September 2018 in 100 cases of sepsis. Patients presenting in emergency with sepsis were included as subjects. C- reactive protein was measured in every patient at the time of admission and after 72 hours. Facts related to history, clinical examination and biochemical parameters were recorded in a pretyped proforma. Data were analyzed using SPSS software.
Results: Males outnumbered females. Most of the patients40(40%) were in the age group of less than 30 years age group. CRP levels were markedly elevated in patients with diabetes mellitus (92.2±102.63) as compared to patients with hypertension (36.66±26.97) or both (24.20±12.87). CRP levels were higher in alcoholics (60.59±44.20) as compared to smokers (13.37±10.96). CRP levels decreased significantly after 72 hours compared to CRP levels at the time of admission (p <0.001) across all patients suggestive of acute infection.
Conclusions: Serial CRP measurement, rather than a single determination at the time of admission, is cheap and valuable in the diagnosis of sepsis and in monitoring the response to therapy. CRP levels shows exaggerated response in diabetes mellitus and alcoholics with sepsis in this study.
Metrics
References
Pradhan S, Ghimire A, Bhattarai B, Khanal B, Pokharel K, Lamsal M et al. The role of C-reactive protein as a diagnostic predictor of sepsis in a multidisciplinary Intensive Care Unit of a tertiary care center in Nepal. Indian J Crit Care Med. 2016;20(7): 417-20.
Reny JL, Vuagnat A, Ract C, Benoit MO, Safar M, Fagon JY. Diagnosis and follow-up of infections in intensive care patients: value of C-reactive protein compared with other clinical and biological variables. Crit Care Med. 2002;30(3):529-35.
Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754.
Lee DG, Lee KS, Shim JJ, Yoon SM, Bae HG. Prognostic Value of the C-reactive Protein Levels in the Head Injury. J Kor Neurotraumatol Soc. 2005;1(1):57-60.
Feldman M, Sbong S. Is CRP, like ESR, Age and Gender Dependent? Rheumatology. 2014; (Sunnyvale) 4:134.
Kalil A, Bailey KL. Septic shock. Drugs & Diseases, Critical Care, Medscape, updated: January 5, 2018, Available at: https://emedicine.medscape.com/article/168402-overview.
Castro SP, Nathan P, Shapiro I. Diabetes and Sepsis: Preclinical Findings and Clinical Relevance. Diabe Care. 2011;34(3):771-8.
King DE, Mainous AG, Buchanan TA, Pearson WS. C-Reactive Protein and Glycemic Control in Adults With Diabetes. Diabe Care. 2003; 26(5):1535-9.
Anand A, Maragathamani. Correlation of CRP level with glycemic control in diabetic foot patients and its sequelae. Int Surg J. 2017;4(12):4006-9.
Mattace-Raso FU, Verwoert GC, Hofman A, Witteman JC. Inflammation and incident-isolated systolic hypertension in older adults: the Rotterdam study. J Hypertens. 2010;28(5):892-5.
Hage FG. C-reactive protein and Hypertension. Journal of Human Hypertension. 2014;28:410-5.
Vanbiervliet G, Le Breton F, Rosenthal-Allieri MA, Gelsi E, Marine-Barjoan E, Anty R et al. Serum C-reactive protein: a non-invasive marker of alcoholic hepatitis. Scand J Gastroenterol. 2006;41(12):1473-9.
Pieri G, Agarwal B, Burroughs AK. C-reactive protein and bacterial infection in cirrhosis. Ann Gastroenterol. 2014;27:113-20.
Tonstad S and Cowan JL. C-reactive protein as a predictor of disease in smokers and former smokers: a review. Int J Clin Pract. 2009;63(11):1634-41.
Ohsawa M, Okayama A, Nakamura M, Onoda T, Kato K, Itai K et al. CRP levels are elevated in smokers but unrelated to the number of cigarettes and are decreased by long-term smoking cessation in male smokers. Prev Med. 2005 ;41(2):651-6.