High C-reactive protein and low cholesterol levels are prognostic markers of survival in severe sepsis.
OBJECTIVE
To evaluate serum C-reactive protein and cholesterol as a prognostic factor for survival in patients with severe sepsis.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
The study population consisted of 96 patients (age range, 18-75 years; median, 56 years; men/women ratio, 40:56) in whom severe sepsis was diagnosed.


METHODS
Patients' serum levels of C-reactive protein and cholesterol were measured upon admission to an intensive care unit, two days later, and on the day of discharge from the intensive care unit or on the day of death.


RESULTS
Cholesterol levels were significantly lower among the nonsurviving patients (day 1, 92.2 +/- 25.1 mg/dL; day 2, 92.1 +/- 21.7 mg/dL; death/discharge day, 92.2 +/- 21.7 mg/dL) than surviving patients (day 1, 175.1 +/- 38.6 mg/dL [P < 0.001]; day 2, 173.0 +/- 39.3 mg/dL [P < 0.001]; death/discharge day, 171.8 +/- 39.6 mg/dL [P = 0.010]). Median C-reactive protein levels were significantly higher among the nonsurvivors (day 1, 32 mg/dL [range, 20.5-64.5 mg/dL]; day 2, 33 mg/dL [range, 22-74.5 mg/dL]; death/discharge day, 30 mg/dL [range, 22-57 mg/dL]) than survivors (day 1, 10 mg/dL [range, 6-14 mg/dL]; day 2, 9 mg/dL [range, 5-10 mg/dL]; death/discharge day, 6 mg/dL [range, 3-9 mg/dL]; P < 0.001).


CONCLUSIONS
Serum C-reactive protein and cholesterol are a predictor of survival in patients with severe sepsis. Low cholesterol and high C-reactive protein levels appear as a valuable tool for individual risk assessment in severe sepsis patients and for stratification of high-risk patients in future intervention trials.
Memiş
Dilek
D
Medical Faculty, Trakya University, Edirne 22030, Turkey. dilmemis@mynet.com
Gursoy
Olcay
O
Tasdogan
Muhittin
M
Süt
Necdet
N
Kurt
Imran
I
Türe
Mevlüt
M
Karamanlioğlu
Beyhan
B
D018806:APACHE; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D018805:Sepsis / Q000097:blood / Q000401:mortality*
D015415:Biomarkers; D002097:C-Reactive Protein; D002784:Cholesterol