High-sensitivity C-reactive protein and risk of sepsis.
BACKGROUND
Conventional C-reactive protein assays have been used to detect or guide the treatment of acute sepsis. The objective of this study was to determine the association between elevated baseline high-sensitivity C-reactive protein (hsCRP) and the risk of future sepsis events.


METHODS
We studied data from 30,239 community dwelling, black and white individuals, age ≥45 years old enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Baseline hsCRP and participant characteristics were determined at the start of the study. We identified sepsis events through review of hospital records. Elevated hsCRP was defined as values >3.0 mg/L. Using Cox regression, we determined the association between elevated hsCRP and first sepsis event, adjusting for sociodemographic factors (age, sex, race, region, education, income), health behaviors (tobacco and alcohol use), chronic medical conditions (coronary artery disease, diabetes, dyslipidemia, hypertension, chronic kidney disease, chronic lung disease) and statin use.


RESULTS
Over the mean observation time of 5.7 years (IQR 4.5-7.1), 974 individuals experienced a sepsis event, and 11,447 (37.9%) had elevated baseline hsCRP (>3.0 mg/L). Elevated baseline hsCRP was independently associated with subsequent sepsis (adjusted HR 1.56; 95% CI 1.36-1.79), adjusted for sociodemographics, health behaviors, chronic medical conditions and statin use.


CONCLUSIONS
Elevated baseline hsCRP was associated with increased risk of future sepsis events. hsCRP may help to identify individuals at increased risk for sepsis.
Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama, United States of America. hwang@uabmc.edu
Henry E
HE
Wang
Nathan I
NI
Shapiro
Monika M
MM
Safford
Russell
R
Griffin
Suzanne
S
Judd
Joel B
JB
Rodgers
David G
DG
Warnock
Mary
M
Cushman
George
G
Howard
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D018805:Sepsis / Q000378:metabolism* / Q000382:microbiology
D002097:C-Reactive Protein