Serum C-reactive protein concentration in early abdominal and pulmonary sepsis

Introduction

The objective of this study was to evaluate the C-reactive protein serum levels in patients with pulmonary and abdominal sepsis during the first 5 days of sepsis progression.

Methods

The present investigation was a retrospective cohort study conducted at the university hospital with 345 patients who were admitted to the ICU and diagnosed with sepsis of pulmonary or abdominal origin. Serum C-reactive protein concentrations were measured by the turbidimetric immunoassay. For analysis of C-reactive protein, day 1 was defined as the day on which the patient was clinically diagnosed with sepsis.

Results

Thirty-four patients with sepsis (9.8%), 114 patients with severe sepsis (33.0%), and 197 patients with septic shock (57.2%) were evaluated. The age of the patients was 56.4 ± 19.8 years. The serum C-reactive protein concentrations were higher on the day of sepsis diagnosis in the group with abdominal infection compared with the group with pulmonary sepsis (17.8 ± 10.1 mg/dl vs. 14.9 ± 11.1 mg/ dl, P = 0.025) and remained significantly higher during the first 5 days of sepsis progression. The values of the area under the ROC curve, sensitivity, specificity, and best cutoff points are listed in Table 1.

Table 1 Values of the area under the ROC curve, sensitivity, specificity, and best cutoff points

Conclusion

The accuracy of C-reactive protein for the differential diagnosis of pulmonary and abdominal sepsis is limited, although significantly higher serum levels were observed in patients with abdominal sepsis.