title: Role of C-reactive protein as a biomarker for prediction of the severity of pulmonary exacerbations in patients with cystic fibrosis.
abstract: BACKGROUND
  Pulmonary exacerbation is one of the main risk factors for death in patients with cystic fibrosis. Several biomarkers have proven useful in the diagnosis and treatment of pulmonary exacerbations, although none has been associated with severity. The objective of the present study was to investigate whether C-reactive protein (CRP) level was associated with the severity of pulmonary exacerbation requiring admission to hospital in patients with cystic fibrosis.
  
  
  METHODS
  We designed a severity index for exacerbations based on 4 clinical parameters and determined whether there was an association between CRP levels and severity of the exacerbation. We also investigated the association between CRP and baseline functional and clinical variables.
  
  
  RESULTS
  Twenty-seven patients with cystic fibrosis required 62 admissions to hospital. CRP levels were not significantly associated with the severity index, although they were associated with specific patient characteristics: colonization by Pseudomonas aeruginosa, allergic bronchopulmonary aspergillosis, treatment with oral corticosteroids, and number of severe exacerbations treated with intravenous antibiotics during the previous year.
  
  
  CONCLUSIONS
  CRP level is not associated with the severity of pulmonary exacerbations, but it is associated with specific clinical characteristics. This simple scoring system (severity index) could prove very useful for evaluating the severity of exacerbations.
authors.affiliation: Pulmonology Department, la Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain. rmgiron@gmail.com.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Girón-Moreno
authors.forename: José L
authors.initials: JL
authors.lastname: Justicia
authors.forename: Sara
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Claudia
authors.initials: C
authors.lastname: Valenzuela
authors.forename: Carolina
authors.initials: C
authors.lastname: Cisneros
authors.forename: Rosa Mar
authors.initials: RM
authors.lastname: Gómez-Punter
authors.forename: Gilda
authors.initials: G
authors.lastname: Fernandes-Vasconcelos
authors.forename: Julio
authors.initials: J
authors.lastname: Ancochea
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000097:blood / Q000150:complications; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D003550:Cystic Fibrosis / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000097:blood / Q000150:complications; D011550:Pseudomonas aeruginosa; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein