title: C-reactive protein as a predictor of mortality in patients affected with severe sepsis in intensive care unit.
abstract: BACKGROUND
  Severe sepsis is a primary cause of morbidity and mortality in the intensive care unit (ICU). Numerous biomarkers have been assessed to predict outcome and CRP is widely used. However, the relevance for mortality risk of the CRP level and the day when it is measured have not been well studied. We aimed to assess whether initial and/or third dayCRP values are as good predictors of mortality in ICU patients with severe sepsis as other well-known complex predictors of mortality, i.e., SOFA scores.
  
  
  METHODS
  An observational cohort study was performed in a 20-bed respiratory ICU in a chest disease center. Patients with severe sepsis due to respiratory disease were enrolled in the study. SOFA scores, CRP values on admission and on the third day of hospital stay, and mortality rate were recorded. ROC curves for SOFA scores and CRP values were calculated.
  
  
  RESULTS
  The study included 314 ICU patients with sepsis admitted between January 2009 and March 2010. The mortality rate was 14.2% (n = 45). The area under the curve (AUC) for CRP values and SOFA scores on admission and on the 3rd day in ICU were calculated as 0.57 (CI: 0.48-0.66); 0.72 (CI: 0.63-0.80); 0.72 (CI: 0.64-0.81); and 0.76 (CI: 0.67-0.86), respectively. Sepsis due to nosocomial infection, a CRP value > 100 mg/L and higher SOFA scores on 3rd day, were found to be risk factors for mortality (odds ratio [OR]: 3.76, confidence interval [CI]: 1.68-8.40, p < 0.001, OR: 2.70, CI: 1.41-2.01, p < 0.013, and OR: 1.68, CI: 1.41-2.01, p < 0.0001, respectively).
  
  
  CONCLUSIONS
  The risk of sepsis related mortality appears to be increased when the 3rd day CRP value is greater than 100 mg/dL. Thus, CRP appears to be as valuable a predictor of mortality as the SOFA score.
authors.affiliation: Department of Pulmonology, Respiratory Intensive Care Unit, SB Süreyyapaşa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Soyak Yenişehir Manolya Evleri B3/63, Ümraniye, Istanbul, Turkey. zuhalkarakurt@hotmail.com.
authors.forename: Ozkan
authors.initials: O
authors.lastname: Devran
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Karakurt
authors.forename: Nalan
authors.initials: N
authors.lastname: Adıgüzel
authors.forename: Gökay
authors.initials: G
authors.lastname: Güngör
authors.forename: Ozlem Yazıcıoğlu
authors.initials: OY
authors.lastname: Moçin
authors.forename: Merih Kalamanoğlu
authors.initials: MK
authors.lastname: Balcı
authors.forename: Ece
authors.initials: E
authors.lastname: Celik
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Saltürk
authors.forename: Huriye Berk
authors.initials: HB
authors.lastname: Takır
authors.forename: Feyza
authors.initials: F
authors.lastname: Kargın
authors.forename: Adnan
authors.initials: A
authors.lastname: Yılmaz