High sensitive C-reactive protein for prediction of adverse outcome in acute exacerbation of chronic obstructive pulmonary disease

Pneumologia. 2012 Jul-Sep;61(3):160-2.

Abstract

Hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with a high risk of mortality and complications. The goal of the study is to assess the clinical utility of serum high sensitive C-reactive protein (hs-CRP) at admission in predicting outcome in hospitalized patients with AECOPD.

Methods: Consecutive patients with AECOPD admitted to a public teaching hospital were studied prospectively. The adverse outcome defined occurrence of one or more of: (1) death in hospital or within 30 days after discharge, (2) transfer to the intensive care unit, or (3) intubation and mechanical ventilation. The correlation of hs-CRP with duration of hospitalization and FEV1% of predicted is also calculated.

Results: Of 60 patients, 22 had adverse outcome and 38 good outcomes. There were no significant differences between two group for mean age, gender, smoking status, and previous hospitalizations (p > 0.05). The adverse outcome rate was 56.5% in those with serum hs-CRP equal or more than 100 mg/ml versus 24.3% in patients with hs-CRP less 100 mg/ml (p = 0.01).

Conclusions: Serum hs-CRP at admission is a predictor of outcome in AECOPD. Admission hs-CRP higher than 100 mg/ml was associated with near fourfold increased probability of adverse outcome.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Female
  • Forced Expiratory Volume
  • Hospitals, University
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / blood*
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Risk Assessment
  • Risk Factors
  • Secondary Prevention
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Time Factors

Substances

  • Biomarkers
  • C-Reactive Protein