title: Serum C-reactive protein level is a predictive factor for 14-day mortality of patients with advanced cancer who present to the emergency department with acute symptoms.
abstract: OBJECTIVE
  This study aimed to investigate the potential of C-reactive protein (CRP) as a predictor of death within 14 days in acutely symptomatic patients with advanced cancer admitted to the emergency department (ED).
  
  
  METHODS
  A prospective observational study was conducted of 126 consecutive patients with advanced cancer who were admitted to the ED because of acute symptoms. The patients were categorized into two groups according to serum CRP levels (cutoff 9.2 mg/dL). Demographic characteristics, disease-related factors, clinical symptoms and signs, and laboratory data were collected. Univariate and multivariate analyses were performed to evaluate the relationship between clinical findings and 14-day mortality.
  
  
  RESULTS
  Median survival was 26.5 days (interquartile range = 8.0-79.5 days). In univariate analysis, serum CRP level (≥9.2 mg/dL), chemotherapy, age (≥65 years), altered mental status, hypotension, and leukocytosis were significant. Multivariate regression analysis revealed that among these variables, serum CRP level (hazard ratio [HR] = 2.444, 95% confidence interval [CI] = 1.298 to 4.603, p = 0.006) and chemotherapy (HR = 0.452, 95% CI = 0.236 to 0.863, p = 0.016) were independent prognostic factors for 14-day mortality.
  
  
  CONCLUSIONS
  Serum CRP levels may provide information on death within 14 days after the ED visit in patients with advanced cancer.
authors.affiliation: Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea.
authors.forename: Jong S
authors.initials: JS
authors.lastname: Lee
authors.forename: Oh Y
authors.initials: OY
authors.lastname: Kwon
authors.forename: Han S
authors.initials: HS
authors.lastname: Choi
authors.forename: Hoon P
authors.initials: HP
authors.lastname: Hong
authors.forename: Young G
authors.initials: YG
authors.lastname: Ko
mesh_terms: D000208:Acute Disease; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein