Valor de la determinación de la proteína C reactiva como marcador pronóstico y de infección en pacientes críticos

Seller-Pérez, G.; Herrera-Gutiérrez, M.E.; Lebrón-Gallardo, Miguel; Toro-Peinado, Inmaculada de; Martín-Hita, Lina; Porras-Ballesteros, José A.

doi:10.1016/s0025-7753(05)72184-9

Cited by 16 publications

(4 citation statements)

References 27 publications

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“…It has been suggested that CRP levels could impact on the prognosis of ICU patients by some studies done in septic dogs and humans [5-7,14]. Gebhardt et al [7] declared that the change in initial and third day control CRP levels was better for predicting mortality than initial CRP, and a fall in the third day CRP level demonstrated corrected survival with 94% accuracy in a study with septic dogs.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit

Devran¹,

Karakurt²,

Adıgüzel³

et al. 2012

Multidiscip Respir Med

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BackgroundSevere sepsis is a primary cause of morbidity and mortality in the intensive care unit (ICU). Numerous biomarkers have been assessed to predict outcome and CRP is widely used. However, the relevance for mortality risk of the CRP level and the day when it is measured have not been well studied. We aimed to assess whether initial and/or third dayCRP values are as good predictors of mortality in ICU patients with severe sepsis as other well-known complex predictors of mortality, i.e., SOFA scores.MethodsAn observational cohort study was performed in a 20-bed respiratory ICU in a chest disease center. Patients with severe sepsis due to respiratory disease were enrolled in the study. SOFA scores, CRP values on admission and on the third day of hospital stay, and mortality rate were recorded. ROC curves for SOFA scores and CRP values were calculated.ResultsThe study included 314 ICU patients with sepsis admitted between January 2009 and March 2010. The mortality rate was 14.2% (n = 45). The area under the curve (AUC) for CRP values and SOFA scores on admission and on the 3rd day in ICU were calculated as 0.57 (CI: 0.48-0.66); 0.72 (CI: 0.63-0.80); 0.72 (CI: 0.64-0.81); and 0.76 (CI: 0.67-0.86), respectively. Sepsis due to nosocomial infection, a CRP value > 100 mg/L and higher SOFA scores on 3rd day, were found to be risk factors for mortality (odds ratio [OR]: 3.76, confidence interval [CI]: 1.68-8.40, p < 0.001, OR: 2.70, CI: 1.41-2.01, p < 0.013, and OR: 1.68, CI: 1.41-2.01, p < 0.0001, respectively).ConclusionsThe risk of sepsis related mortality appears to be increased when the 3rd day CRP value is greater than 100 mg/dL. Thus, CRP appears to be as valuable a predictor of mortality as the SOFA score.

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Section: Discussionmentioning

confidence: 99%

C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit

Devran¹,

Karakurt²,

Adıgüzel³

et al. 2012

Multidiscip Respir Med

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“…In an Australian study a cohort value for the CRP values was obtained, mentioning a 7% risk of death with levels greater than 150mg/dl and up to 21% when levels are greater than 300mg/dl [23]. With regards to the utility of CRP as a prognostic marker, the majority of studies failed to demonstrate any correlation between CRP concentration and the survival [24].…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin versus C-Reactive Protein in Neonatal Sepsis

Am¹,

Wf²,

Ss³

2014

Journal of Immunology and Infectious Diseases

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Objectives: To compare between C-reactive protein (CRP) and Procalcitonin (PCT) regarding diagnosis and outcome of neonatal sepsis. Urinary tract infection (UTI) is the most common serious bacterial infection in febrile children younger than 3 months, with reported rates ranging from 5% to 20% depending on different series. Neonates and infants up to age 2 months who have pyelonephritis usually do not have symptoms localized to the urinary tract. UTI is discovered as part of an evaluation for neonatal sepsis [1]. Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteremia occurring in the first month of life. The overall incidence of primary sepsis is 1-5/1000 live births. The incidence is much higher for very low birth weight infants (birth weight<1500gm) [2]. Since the clinical manifestations of sepsis in neonates are non-specific and associated with high morbidity and mortality, early suspicion and treatment before blood culture confirmation is crucial [3]. The mortality rate is high (13-25%) with higher rates seen in premature infants, those with early fulminant disease [2] and those with increasing severity of inflammation. Background Procalcitonin versus C-Reactive Protein in Neonatal SepsisThe most severe infection is complicated by systemic inflammation and septic shock. However, to start therapy, an early reliable diagnosis is necessary [4]. Clinical signs and symptoms of infection often don't point towards the etiology. The diagnosis of sepsis is difficult because of non-specificity of clinical signs and symptoms and overlapping of symptoms with other noninfectious causes of systemic inflammation [5]. Elevated CRP levels are seen in infection, autoimmune disease, surgery, meconium aspiration and recent vaccination. Also, the CRP values do not rise significantly until almost 24-48 hr after the onset of infection [6,7].Participants: Seventy newborn Infants admitted to NICU for sepsis management.Results: Of the total 70 Neonates admitted in NICU, 31.4%, 42.9% and 25.7% were categorized as proven sepsis, suspected sepsis and clinical sepsis respectively. Procalcitonin was positive in 100% compared to the CRP positivity in 63.6% of the proven sepsis cases. Mortality rate is significantly increased in proven sepsis compared to clinical sepsis.Intervention: Sepsis workup laboratory tests. Main Outcome Measures:Specific diagnostic and prognostic impact of the tests. Conclusion:Comparing with CRP, PCT is not only a good diagnostic measure of neonatal sepsis but also effective predictor of sepsis outcome.

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“…No signs of peritoneal irritation were observed. The laboratory analysis revealed only an elevated C-reactive protein level of 81 mg/L (this is an indicator of mortality in cases of abdominal sepsis [ 15 ], normal values are around 5 mg/L [ 16 ]), while other parameters were within the normal range.…”

Section: Case Descriptionmentioning

confidence: 99%

Intestinal Obstruction for Anisakiasis: Surgical and Physical Therapy Treatment

Cózar-Bernal,

Góngora-Rodríguez,

Ayala-Martínez

et al. 2023

JCM

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Anisakiasis, a zoonotic disease that can lead to small intestine obstruction, has seen a significant rise in Spain. The country has become the first in Europe with an annual incidence of 8000 cases, primarily due to the popularity of consuming exotic dishes of undercooked or raw fish and the impact of climate change. The clinical presentation of anisakiasis can mimic symptoms of acute appendicitis or intestinal obstruction, leading to potential misdiagnosis. This case report describes a 37-year-old patient with no significant medical history who presented abdominal distension and intense pain in the right lower quadrant. The patient underwent surgery and received physiotherapy treatment, including therapeutic exercises and pulsed-pressure myofascial vacuum therapy, to facilitate functional recovery. The increasing incidence of anisakiasis in Spain underscores the need to consider it in the differential diagnosis of digestive diseases, given the high consumption of poorly prepared or raw fish in the region.

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Valor de la determinación de la proteína C reactiva como marcador pronóstico y de infección en pacientes críticos

Cited by 16 publications

References 27 publications

C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit

C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit

Procalcitonin versus C-Reactive Protein in Neonatal Sepsis

Intestinal Obstruction for Anisakiasis: Surgical and Physical Therapy Treatment

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