Serum C-reactive protein concentrations in early abdominal and pulmonary sepsis

Rev Bras Ter Intensiva. 2013 Mar;25(1):6-11. doi: 10.1590/s0103-507x2013000100003.
[Article in English, Portuguese]

Abstract

Objectives: To evaluate the C-reactive protein serum levels in patients with pulmonary and abdominal sepsis during the first five days of sepsis progression.

Methods: The present investigation was a retrospective cohort study conducted at the university hospital with 345 patients who were admitted to the intensive care unit and diagnosed with sepsis of pulmonary or abdominal origin. Serum C-reactive protein concentrations were measured by the turbidimetric immunoassay. For analysis of C-reactive protein, day 1 was defined as the day on which the patient was clinically diagnosed with sepsis.

Results: Thirty-four patients with sepsis (9.8%), 114 patients with severe sepsis (33.0%), and 197 patients with septic shock (57.2%) were evaluated. The age of the patients was 56.4 ± 19.8 years. The serum C-reactive protein concentrations were higher on the day of sepsis diagnosis in the group with abdominal infection compared with the group with pulmonary sepsis (17.8 ± 10.1 mg/dL versus 14.9 ± 11.1 mg/dL, p=0.025) and remained significantly higher during the first five days of sepsis progression.

Conclusion: The serum C-reactive protein concentrations were significantly higher in the patients with abdominal sepsis compared with the patients with pulmonary sepsis during the first five days of sepsis progression.

Objetivo: Avaliar os níveis séricos de proteína C-reativa em pacientes com sepse pulmonar e abdominal nos primeiros 5 dias de progressão da sepse.

Métodos: Estudo de coorte retrospectivo em hospital universitário. Foram selecionados 345 pacientes admitidos em unidade de terapia intensiva e diagnosticados com sepse de origem pulmonar ou abdominal. A dosagem sérica de proteína C-reativa foi realizada por imunoensaio turbidimétrico. Para análises da proteína C-reativa, o dia 1 foi definido como o do diagnóstico clínico da sepse.

Resultados: Foram avaliados 34 pacientes com sepse (9,8%), 114 com sepse grave (33,0%) e 197 com choque séptico (57,2%). A idade dos pacientes foram 56,4±19,8 anos. Concentrações séricas de proteína C-reativa foram mais elevadas no dia do diagnóstico de sepse no grupo com infecção de origem abdominal em comparação ao grupo com sepse pulmonar (17,8±10,1 mg/dL versus 14,9±11,1 mg/dL; p=0,025) e mantiveram-se significativamente mais elevadas nos primeiros 5 dias de evolução da sepse.

Conclusão: As concentrações séricas de proteína C-reativa foram significativamente mais elevadas nos pacientes com sepse de origem abdominal do que em pacientes com sepse de origem pulmonar nos 5 primeiros dias de evolução da sepse.

MeSH terms

  • Abdomen
  • Adult
  • Aged
  • C-Reactive Protein / analysis*
  • Cohort Studies
  • Disease Progression
  • Female
  • Hospitals, University
  • Humans
  • Intensive Care Units*
  • Lung Diseases / complications
  • Male
  • Middle Aged
  • Nephelometry and Turbidimetry
  • Retrospective Studies
  • Sepsis / blood*
  • Sepsis / etiology
  • Shock, Septic / blood*
  • Shock, Septic / etiology

Substances

  • C-Reactive Protein