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Does C‐reactive protein independently predict mortality in adult community‐acquired bacteremia patients with known sepsis severity?
Authors:Kim O Gradel  Thøger G Jensen  Hans J Kolmos  Court Pedersen  Pernille J Vinholt  Annmarie T Lassen
Institution:1. Research Unit of Clinical Epidemiology, Centre for National Clinical Databases, South, Odense University Hospital, , Odense, Denmark;2. Department of Clinical Microbiology, Odense University Hospital, , Odense, Denmark;3. Department of Infectious Diseases, Odense University Hospital, , Odense, Denmark;4. Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, , Odense, Denmark;5. Department of Emergency Medicine, Odense University Hospital, , Odense, Denmark
Abstract:We evaluated whether sepsis severity and C‐reactive protein (CRP) level on admission prognostically corroborated or annulled each other in adult patients with incident community‐acquired bacteremia (Funen, Denmark, 2000–2008). We used logistic regression and area under the receiver operating characteristic curve (AUC) to evaluate 30‐day mortality in four models: (i) age, gender, comorbidity, bacteria, and ward. (ii) Model 1 and sepsis severity. (iii) Model 1 and CRP. (iv) Model 1, sepsis severity, and CRP. Altogether, 416 of 1999 patients died within 30 days. CRP independently predicted 30‐day mortality Model 4, odds ratio (95% CIs) for 100 mg/L: 1.16 (1.06–1.27)], but it did not contribute to the AUC (Model 2 vs Model 4: p = 0.31). In the 963 non‐severe sepsis patients, CRP independently predicted 30‐day mortality Model 4: 1.42 (1.20–1.69)] and it increased the AUC (Model 2 vs Model 4: p = 0.06), thus CRP contributed as much as sepsis severity to prognosis.
Keywords:C‐reactive protein  sepsis severity  adults  community acquired bacteremia  short‐term mortality
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