Volume 17 Supplement 3

Seventh International Symposium on Intensive Care and Emergency Medicine for Latin America

Open Access

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

  • JA Orati1 and
  • SM Lobo2
Critical Care201317(Suppl 3):P53

https://doi.org/10.1186/cc12669

Published: 19 June 2013

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

ROC curve

AUC (95% CI)

Sensitivity

Specificity

Cutoff (mg/dl)

CRP day 1

0.53 (0.43 to 0.62)

0.26

0.88

6.12

CRP day 2

0.51 (0.41 to 0.60)

0.67

0.42

18.6

CRP day 3

0.52 (0.43 to 0.61)

0.57

0.56

13.6

CRP day 4

0.51 (0.41 to 0.60)

0.42

0.65

14.2

CRP day 5

0.59 (0.48 to 0.68)

0.58

0.62

9.10

AUC, area under the ROC curve; CI, confidence interval; CRP, C-reactive protein; ROC, receiver operator characteristic.

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.

Authors’ Affiliations

(1)
University of Ribeirão Preto
(2)
Hospital de Base de São José do Rio Preto

Copyright

© Orati et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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