Internal and Emergency Medicine

, Volume 6, Issue 5, pp 423–430

Prognostic value of C-reactive protein in chronic obstructive pulmonary disease

  • Massimo Miniati
  • Simonetta Monti
  • Matteo Bottai
  • Franca Cocci
  • Edo Fornai
  • Valter Lubrano
IM - Original

DOI: 10.1007/s11739-011-0520-z

Cite this article as:
Miniati, M., Monti, S., Bottai, M. et al. Intern Emerg Med (2011) 6: 423. doi:10.1007/s11739-011-0520-z

Abstract

To establish whether C-reactive protein (CRP) is an independent predictor of all-cause mortality and hospitalization in chronic obstructive pulmonary disease (COPD), we followed 200 patients with COPD and 201 age- and gender -matched controls for a median time of 4.2 years (range, 0.2–5.1 years). Airflow obstruction was rated moderate if forced expiratory volume in one second (FEV1) was 50–69% of the predicted value, or severe if FEV1 was <50%. The CRP level was categorized as low (≤3 mg/L) or high (>3 mg/L). The hazard of death was estimated by a proportional hazard regression model, using controls with low CRP as the reference category. Fifty subjects died: 41 (21%) among the COPD and 9 (4%) among the controls (p < 0.0001). The hazard of death in moderate COPD was not significantly higher than in the reference category, independently of the CRP level. In severe COPD with a low CRP, the hazard of death is 3.4 times higher than in the reference category (p = 0.008); in severe COPD and a high CRP it is 9.6 times higher (p < 0.0001). The rate of hospitalization in COPD patients with a high CRP is 1.9 times higher than in those with a low CRP [95% confidence interval (CI), 1.2–3.2]. In severe COPD, it is 6.9 times higher than in moderate COPD (95% CI, 3.8–12.7). A high CRP level is a significant amplifier of the risk of death only in severe COPD. The degree of airflow obstruction is a strong independent predictor of COPD-related outcomes.

Keywords

C-reactive proteinChronic obstructive pulmonary diseaseSurvival

Copyright information

© SIMI 2011

Authors and Affiliations

  • Massimo Miniati
    • 1
  • Simonetta Monti
    • 2
    • 3
  • Matteo Bottai
    • 4
    • 5
  • Franca Cocci
    • 2
    • 3
  • Edo Fornai
    • 2
    • 3
  • Valter Lubrano
    • 2
    • 3
  1. 1.Dipartimento di Area Critica Medico-ChirurgicaUniversità di FirenzeFlorenceItaly
  2. 2.Istituto di Fisiologia Clinica del Consiglio Nazionale delle Ricerche (CNR)PisaItaly
  3. 3.Fondazione CNR-Regione Toscana “G. Monasterio”PisaItaly
  4. 4.Unit of Biostatistics, Department of Environmental MedicineKarolinska InstitutetStockholmSweden
  5. 5.Division of Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA