[Blood concentrations of lactate, C-reactive protein, and creatinine as early indicators of severity and outcome of sepsis].
BACKGROUND
Since the outcome in septic patients can significantly be improved if the appropriate therapy is introduced timely early, the early diagnosis of sepsis and its complications is essential. The aim of this study was to compare mean values of the initial blood concentrations of lactate, C-reactive protein and creatinine and the severity of illness and the outcome of sepsis.


METHODS
A total of 30 septic patients were included in the study. The diagnosis of sepsis and its complications was made according to consensus criteria. The severity of illness was scored by an acute physiology, age and chronic health evaluation septic score. The patients were subdivided into different groups, those with sepsis, severe sepsis or septic shock, those with or without multiple organ dysfunction syndrome, and survivors and nonsurvivors.


RESULTS
The differences in mean values of lactate levels among all studied groups were significantly high, whereas the level of C-reactive protein were significantly higher only in the non-survivors compared to the survivors (p < 0.05). The concentrations of creatinine were significantly higher in the patients with septic shock compared to the patients with sepsis, and in the patients with multiple organ dysfunction syndrome and the non-survivors compared to the corresponding groups (p < 0.05). The septic score clearly discriminated patients with different severity of sepsis, development of multiple organ dysfunction syndrome and survival and positively correlated with the concentrations of lactate, C-reactive protein and creatinine (the best correlation ranks were with lactate levels, p < 0.001).


CONCLUSIONS
Our results suggest that lactate level is a better parameter of illness severity and outcome of sepsis than levels of C-reactive protein and creatinine. When compared to the above parameters, the septic score determined on the day of admission to hospital is a much better criterion to classify patients into groups with different severity of sepsis, with and without multiple organ dysfunction syndrome and into survivors and non-survivors.
Vojnomedicinska akademnija, Klinika za infektivne i tropske bolesti, Beograd.
Dragan
D
Mikić
Gordana
G
Arsić-Komljenović
Darko
D
Nozić
Milica
M
Cućuz
Radmila
R
Dimitrijević
Jovan
J
Vukadinov
D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D012772:Shock, Septic / Q000097:blood / Q000150:complications / Q000175:diagnosis
D015415:Biomarkers; D019344:Lactic Acid; D002097:C-Reactive Protein; D003404:Creatinine