C-reactive protein levels on admission are correlated with mortality and organ failures in critically ill patients

Objective

C-reactive protein (CRP) increases in response to infection, trauma, ischemia, burns, and inflammatory conditions. Although used frequently in the ICU setting as a marker of systemic inflammation, its relation with organ damage is not well known. This study assessed the association between early serum CRP levels and the development of organ failure (OF) and mortality in ICU patients.

Design

A prospective cohort study conducted in a 31-bed intensive care unit of a university hospital.

Patients

A total of 307 admitted within a 4-month period.

Measurements and main outcomes

At admission, the 223 patients (73%) who developed at least one organ failure during the ICU stay had significantly higher CRP concentrations than the 84 patients (27%) without organ failure (8.4 ± 10.3 versus 3.2 ± 4.8 mg/dl; P < 0.05; Figure overleaf). The number of organs failing during the ICU stay raised with increasing CRP concentrations on ICU admission (two OF, 8.2 ± 11 mg/dl; three OF, 9.8 ± 8.3 mg/dl; and four OF, 14 ± 4.3 mg/dl). Nonsurvivors had significantly higher CRP levels than survivors on ICU admission (10.0 ± 11.0 versus 6.0 ± 8.5; P < 0.05; Figure overleaf).

Conclusion

Elevated concentrations of serum CRP on admission are potential indicators of an increased risk of organ failure and dying.