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Serum C-reactive Protein Level Is a Predictive Factor for 14-Day Mortality of Patients With Advanced Cancer Who Present to the Emergency Department With Acute Symptoms
ACADEMIC EMERGENCY MEDICINE 2011; 18:440–442 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: This study aimed to investigate the potential of C-reactive protein (CRP) as a predictor of death within 14 days in acutely symptomatic patients with advanced cancer admitted to the emergency department (ED). Methods: A prospective observational study was conducted of 126 consecutive patients with advanced cancer who were admitted to the ED because of acute symptoms. The patients were categorized into two groups according to serum CRP levels (cutoff 9.2 mg/dL). Demographic characteristics, disease-related factors, clinical symptoms and signs, and laboratory data were collected. Univariate and multivariate analyses were performed to evaluate the relationship between clinical findings and 14-day mortality. Results: Median survival was 26.5 days (interquartile range = 8.0–79.5 days). In univariate analysis, serum CRP level (≥9.2 mg/dL), chemotherapy, age (≥65 years), altered mental status, hypotension, and leukocytosis were significant. Multivariate regression analysis revealed that among these variables, serum CRP level (hazard ratio [HR] = 2.444, 95% confidence interval [CI] = 1.298 to 4.603, p = 0.006) and chemotherapy (HR = 0.452, 95% CI = 0.236 to 0.863, p = 0.016) were independent prognostic factors for 14-day mortality. Conclusions: Serum CRP levels may provide information on death within 14 days after the ED visit in patients with advanced cancer.
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