The value of serum C-reactive protein levels as a marker of sepsis in intensive care unit patients.
A one-year prospective study was carried out to assess the value of routine serum C-reactive protein (CRP) measurement in the early diagnosis of infection in ICU patients of a District General Hospital. Ninety-one patients were included in the study. Sixty-eight patients yielded 28 proved and 77 suspected episodes of infection. Control data were drawn from 23 uninfected ICU patients. Both absolute values and percentage rates of change were examined for the following variables: serum CRP, maximum daily temperature and peripheral white blood cell count. Neither absolute CRP levels nor rates of change in CRP were found to relate significantly to proved infection. In the group in whom infection was suspected but not proved, absolute CRP levels were higher than controls on the day before the suspected infection (p = 0.019), but were not significantly raised on the day of infection nor the day after. The only significant rises in CRP (> 25%) were found in the suspected infection group from the day before to the day of infection, when compared with controls (p = 0.04). Traditional markers of infection--maximum temperature and peripheral white blood cell count--were significantly associated with infection. Maximum temperature was significantly higher in both proved and suspected infection on the day before infection (p = 0.000 and 0.001), and on the day of infection (p = 0.025 and 0.03), compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Parnaby
R M
RM
Department of Microbiology, Central Middlesex Hospital NHS Trust, London, UK.
Eaton
S E
SE
Shafi
M S
MS
Bell
D
D
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D002097:C-Reactive Protein / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood*