title: Does C-reactive protein independently predict mortality in adult community-acquired bacteremia patients with known sepsis severity?
abstract: We evaluated whether sepsis severity and C-reactive protein (CRP) level on admission prognostically corroborated or annulled each other in adult patients with incident community-acquired bacteremia (Funen, Denmark, 2000-2008). We used logistic regression and area under the receiver operating characteristic curve (AUC) to evaluate 30-day mortality in four models: (i) age, gender, comorbidity, bacteria, and ward. (ii) Model 1 and sepsis severity. (iii) Model 1 and CRP. (iv) Model 1, sepsis severity, and CRP. Altogether, 416 of 1999 patients died within 30 days. CRP independently predicted 30-day mortality [Model 4, odds ratio (95% CIs) for 100 mg/L: 1.16 (1.06-1.27)], but it did not contribute to the AUC (Model 2 vs Model 4: p = 0.31). In the 963 non-severe sepsis patients, CRP independently predicted 30-day mortality [Model 4: 1.42 (1.20-1.69)] and it increased the AUC (Model 2 vs Model 4: p = 0.06), thus CRP contributed as much as sepsis severity to prognosis.
authors.affiliation: Research Unit of Clinical Epidemiology, Centre for National Clinical Databases, South, Odense University Hospital, Odense, Denmark. kim.gradel@ouh.regionsyddanmark.dk
authors.forename: Kim O
authors.initials: KO
authors.lastname: Gradel
authors.forename: Thøger G
authors.initials: TG
authors.lastname: Jensen
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Kolmos
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.forename: Pernille J
authors.initials: PJ
authors.lastname: Vinholt
authors.forename: Annmarie T
authors.initials: AT
authors.lastname: Lassen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D002097:C-Reactive Protein / Q000378:metabolism*; D017714:Community-Acquired Infections / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; adults; community acquired bacteremia; sepsis severity; short-term mortality