Does C‐reactive protein independently predict mortality in adult community‐acquired bacteremia patients with known sepsis severity?

Authors: Gradel, Kim O.; Jensen, Thøger G.; Kolmos, Hans J.; Pedersen, Court; Vinholt, Pernille J.; Lassen, Annmarie T.

Source: Apmis, Volume 121, Number 9, 1 September 2013 , pp. 835-842(8)

Publisher: Wiley-Blackwell

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Abstract:

We evaluated whether sepsis severity and C‐reactive protein (CRP) level on admission prognostically corroborated or annulled each other in adult patients with incident community‐acquired bacteremia (Funen, Denmark, 2000–2008). We used logistic regression and area under the receiver operating characteristic curve (AUC) to evaluate 30‐day mortality in four models: (i) age, gender, comorbidity, bacteria, and ward. (ii) Model 1 and sepsis severity. (iii) Model 1 and CRP. (iv) Model 1, sepsis severity, and CRP. Altogether, 416 of 1999 patients died within 30 days. CRP independently predicted 30‐day mortality [Model 4, odds ratio (95% CIs) for 100 mg/L: 1.16 (1.06–1.27)], but it did not contribute to the AUC (Model 2 vs Model 4: p = 0.31). In the 963 non‐severe sepsis patients, CRP independently predicted 30‐day mortality [Model 4: 1.42 (1.20–1.69)] and it increased the AUC (Model 2 vs Model 4: p = 0.06), thus CRP contributed as much as sepsis severity to prognosis.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/apm.12040

Publication date: September 1, 2013

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