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The value of C-reactive protein in infection diagnosis and prognosis in elderly patients

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Abstract

Background

The aim of this study was to determine the value of C-reactive protein level in the diagnosis and prognosis of infection in elderly patients.

Study population

This prospective study included inpatients in the palliative care unit during the 1-year period between January 2016 and January 2017. Patients’ demographic data, Acute Physiology and Chronic Health Evaluation score, and Charlson Comorbidity Index were recorded.

Results

A total of 233 patients were included in the study. A total of 199 instances of infection were diagnosed in 175 of those patients; 75.3% of the infections were detected at admission and 24.7% during hospitalization. At a cut-off value of 4.82, CRP value had 81.0% specificity and 75.4% sensitivity in the diagnosis of infection. Among the patients with infection, there was no difference between those who died and those who survived in terms of baseline CRP level, but a significant difference emerged in CRP level at 48 and 96 h. Factors which were found to significantly reduce survival time were the presence of chronic kidney disease, chronic obstructive pulmonary disease, hypoxia and tachycardia at admission, APACHE-II score over 20.5, initial albumin level below 2.44 g/dL, and serum CRP clearance rates of less than 11% at 48 h and 20% at 96 h.

Conclusion

In elderly patients with infection, the initial CRP value alone does not have prognostic value, but changes observed in serial CRP measurement are a valid indicator of prognosis.

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Authors and Affiliations

  1. Erzurum Regional Training and Research Hospital, Infectious Diseases Clinic, Erzurum, Turkey

    Omer Karasahin

  2. Erzurum Regional Training and Research Hospital, Geriatrics Clinic, Erzurum, Turkey

    Pınar Tosun Tasar

  3. Erzurum Regional Training and Research Hospital, Internal Medicine Clinic, Erzurum, Turkey

    Ozge Timur, Filiz Yıldırım & Dogan Nasır Binici

  4. Division of Geriatrics, Department of Internal Medicine, Ege University Hospital, Izmir, Turkey

    Sevnaz Sahin

Authors
  1. Omer Karasahin
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  2. Pınar Tosun Tasar
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  3. Ozge Timur
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  4. Filiz Yıldırım
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  5. Dogan Nasır Binici
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  6. Sevnaz Sahin
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Correspondence to Pınar Tosun Tasar.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Karasahin, O., Tasar, P.T., Timur, O. et al. The value of C-reactive protein in infection diagnosis and prognosis in elderly patients. Aging Clin Exp Res 30, 555–562 (2018). https://doi.org/10.1007/s40520-017-0821-9

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  • DOI: https://doi.org/10.1007/s40520-017-0821-9

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