C-reactive protein as a prognostic factor in intensive care admissions for sepsis: A Swedish multicenter study
C-reactive protein as a prognostic factor in intensive care admissions for sepsis: A Swedish multicenter study
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DOI：
10.1016/j.jcrc.2019.12.009
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发表时间：
2020-04-01
影响因子：
3.7
通讯作者：
Frigyesi, Attila
中科院分区：
文献类型：
--
作者：
Koozi, Hazem;Lengquist, Maria;Frigyesi, Attila
目的：C反应蛋白(CRP)不包括在主要重症监护病房(ICU)的预后工具中，如简化急性生理学评分(SAPS)。我们评估了ICU入院时的CRP水平，将其作为ICU脓毒症患者短期死亡率和住院时间(LOS)的独立危险标志物。材料和方法：对瑞典南部四家医院符合脓毒症-3标准的成人ICU患者进行回顾性鉴定，并根据入院时的CRP水平将其分为低C反应蛋白组(100 mg/L)。计算标化死亡率。结果：共入院851例。高CRP组SMR较高(整个脓毒症组0.85比0.67，P=.001；培养阳性亚组0.85比0.59，P=0.003)。在存活患者中，CRP水平还与ICU和医院LOS相关(P<；.001和P.002)，同样独立于SAPS-3。结论：无论SAPS-3的发病率如何，入院时CRP100 mg/L与存活患者ICU和30d死亡率的增加以及LOS的延长有关。因此，在ICU的脓毒症住院患者中，CRP可能是一个简单的、早期的预后标志物。(C)2019年由Elsevier Inc.出版。
Purpose: C-reactive protein (CRP) is not included in the major intensive care unit (ICU) prognostic tools such as the Simplified Acute Physiology Score (SAPS). We assessed CRP on ICU admission as a SAPS-3 independent risk marker for short-term mortality and length of stay (LOS) in ICU patients with sepsis.Materials and methods: Adult ICU admissions satisfying the Sepsis-3 criteria to four southern Swedish hospitals were retrospectively identified and divided into a low CRP group (100 mg/L) based on the admission CRP level. The standardized mortality ratio (SMR) was calculated.Results: A total of 851 admissions were induded. The SMR was higher in the high CRP group (0.85 vs. 0.67, P = .001 in the whole sepsis group and 0.85 vs. 0.59, P = .003 in the culture-positive subgroup). The CRP levels also correlated with ICU and hospital LOS in survivors (P < .001 and P .002), again independent of SAPS-3.Conclusion: An admission CRP level >100 mg/L is associated with an increased risk of ICU and 30-day mortality as well as prolonged LOS in survivors, irrespective of morbidity measured with SAPS-3. Thus, CRP may be a simple, early marker for prognosis in ICU admissions for sepsis. (C) 2019 Published by Elsevier Inc.