Combined efficacy of C-reactive protein and red blood cell distribution width in prognosis of patients with culture-negative infective endocarditis

Abstract

ObjectiveTo evaluate the combined effect of C-reactive protein (CRP) and red blood cell distribution width (RDW) on the prediction of in-hospital and long-term poor outcomes in patients with blood culture-negative infective endocarditis (BCNE).ResultsPatients with high CRP and high RDW has the highest incidence of in-hospital death (2.3% vs. 7.8% vs. 5.6% vs. 17.5%, P < 0.001). CRP > 17.8 mg/L (odds ratio [OR]=2.41, 95% confidence interval [CI], 1.06–5.51, P = 0.037), RDW >16.3 (OR = 2.29, 95% CI, 1.10–4.77, P = 0.027), and these two values in combination (OR = 3.15, 95% CI, 1.46–6.78, P=0.003) were independently associated with in-hospital death. Patients with RDW > 16.3 had higher long-term mortality (P = 0.003), while no significant correlation was observed for CRP (P = 0.151).Materials and MethodsIn total, 572 participants with BCNE were consecutively enrolled. They were classified into four groups based on the optimal CRP and RDW cut-off values (which were determined using a receiver operating characteristic analysis): low CRP and low RDW (n = 216), high CRP and low RDW (n = 129), low CRP and high RDW (n = 107), and high CRP and high RDW (n = 120).ConclusionsIncreased CRP and RDW, especially in combination, are independently associated with in-hospital death in BCNE. RDW, but not CRP, has long-term prognostic value.

Evaluation of Laboratory Predictors for In-Hospital Mortality in Infective Endocarditis and Negative Blood Culture Pattern Characteristics

“…Several studies proved the predictive value of CRP for IE outcome, namely, in monitoring antimicrobial treatment. Its progressive decrease can suggest a favorable response, while persistent high values suggest complications and/or antibiotic resistance and induce the need for further investigations [ 20 , 21 ]. Our analysis also showed a good predictive value of high CRP levels for a negative outcome of disease.…”

Clinical characteristics of geriatric patients with non-specific chronic low back pain

“…Elevated RDW is associated with an increased risk of age-related diseases and mortality; moreover, RDW reflects overall inflammation because it is associated with overall and disease-specific mortality risk 41 , 42 . Veeranna 43 and Wei 44 performed comparative analyses of RDW and CRP for mortality prediction in patients with coronary heart disease and infectious endocarditis, respectively. They concluded that RDW, and not CRP, was associated with mortality, independent of traditional risk factors.…”

“…Cellular senescence is an irreversible process. Unlike traditional biomarkers of acute inflammation, RDW is a valid indicator of senescence because it is not affected by cases of acute inflammation, such as infectious diseases; more so, it increases over time without large fluctuation, and it has a low reversibility 43 , 44 . The study results indicate that age-related physical changes in body composition, such as skeletal muscle loss and fat accumulation, are mechanisms of senescence that occur based on chronic inflammation.…”

Validity of SOFA score as a prognostic tool for critically ill elderly patients with acute infective endocarditis

“…The mortality rate for methicillin-resistant SAB (MRSAB) is 32% and for methicillin susceptible SAB (MSSAB) is 14%, both higher than in other infections. Wei found that increased CRP and red blood cell distribution width, especially in combination, were associated with in-hospital mortality in patients with blood culture-negative infective endocarditis [14]. Other biochemical markers such as troponin, B-Type Natriuretic Peptide and D-dimer are reliable prognostic biomarkers associated with adverse outcomes in patients with IE [15][16][17].…”