Sepsis Related Mortality Associated with an Inflammatory Burst in Patients Admitting to the Department of Internal Medicine with Apparently Normal C-Reactive Protein Concentration

Ronnie Meilik, Hadas Ben-Assayag, Ahuva Meilik, Shlomo Berliner, David Zeltser, Itzhak Shapira, Ori Rogowski, Ilana Goldiner, Shani Shenhar-Tsarfaty, Asaf Wasserman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients who are admitted to the Department of Internal Medicine with apparently normal C-reactive protein (CRP) concentration impose a special challenge due the as-sumption that they might not harbor a severe and potentially lethal medical condition. Methods: A retrospective cohort of all patients who were admitted to the Department of Internal Medicine with a CRP concentration of ≤31.9 mg/L and had a second CRP test obtained within the next 24 h. Seven day mortality data were analyzed. Results: Overall, 3504 patients were analyzed with a mean first and second CRP of 8.8 (8.5) and 14.6 (21.6) mg/L, respectively. The seven day mortality increased from 1.8% in the first quartile of the first CRP to 7.5% in the fourth quartile of the first CRP (p < 0.0001) and from 0.6% in the first quartile of the second CRP to 9.5% in the fourth quartile of the second CRP test (p < 0.0001), suggesting a clear relation between the admission CRP and in hospital seven day mortality. Conclusions: An association exists between the quartiles of CRP and 7-day mortality as well as sepsis related cause of death. Furthermore, the CRP values 24 h after hospital admission improved the discrimination.

Original languageEnglish
Article number3151
JournalJournal of Clinical Medicine
Volume11
Issue number11
DOIs
StatePublished - 1 Jun 2022

Keywords

  • C-reactive protein
  • inflammation
  • mortality causes

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