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01.11.2004 | Original

C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome

verfasst von: Rafael Sierra, Jordi Rello, María Angeles Bailén, Encarnación Benítez, Antonio Gordillo, Cristobal León, Sebastián Pedraza

Erschienen in: Intensive Care Medicine | Ausgabe 11/2004

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Abstract

Objective

To assess the diagnostic value of a single determination of serum C-reactive protein as a marker of sepsis in critically ill patients.

Design

Prospective, observational study.

Setting

Intensive care unit of a university hospital.

Patients and participants

One hundred twenty-five adult patients with systemic inflammatory response syndrome (SIRS) (55 patients without evidence of infection and 70 patients with the diagnosis of sepsis confirmed by documented infection). Twenty-five patients with non-complicated acute myocardial infarctions (AMI) and 50 healthy volunteers were used as controls.

Interventions

None.

Measurements and results

Serum C-reactive protein concentration was measured within the first 24 h of SIRS onset. Healthy subjects, AMI and non-infectious SIRS patients showed lower C-reactive protein median values ([(0.21 [95% confidence intervals (95% CI), 0.21–0.4] mg/dl, 2.2 [95% CI, 2.1–4.9] mg/dl and 1.7 [95% CI, 2.4–5.5] mg/dl, respectively) than patients with sepsis (18.9 [95% CI, 17.1–21.8]), p<0.001. The presence of severe sepsis (r_s=0.27; p=0.03), SOFA score (r_s=0.25; p=0.03) and arterial lactate (r_s=0.24; p=0.04) correlated significantly with C-reactive protein concentrations in sepsis cases. The best threshold value for C-reactive protein for predicting sepsis was 8 mg/dl (sensitivity 94.3%, specificity 87.3%). The area under the receiver-operating characteristic curve for C-reactive protein was 0.94 (95% CI, 0.89–0.98).

Conclusions

Determination of serum C-reactive protein can be used as an early indicator of infection in patients with SIRS.

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Titel: C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome
verfasst von: Rafael Sierra
Jordi Rello
María Angeles Bailén
Encarnación Benítez
Antonio Gordillo
Cristobal León
Sebastián Pedraza
Publikationsdatum: 01.11.2004
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 11/2004
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2434-y

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C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome