Peak C-reactive protein levels do not predict 30-day mortality for bacteremia: A retrospective cohort study |
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Affiliation: | 1. Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;2. Department of Infectious Diseases, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan;3. Department of Emergency Medicine, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan;1. Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;2. Department of Infectious Diseases, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;3. Department of Hematology and Oncology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;4. Clinical Laboratories, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;5. Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan;1. Department of Neonatology, Tokyo Women''s Medical University Yachiyo Medical Center, Chiba, Japan;2. Department of Pediatrics, Tokyo Women''s Medical University Yachiyo Medical Center, Chiba, Japan;3. Department of Neurosurgery, Tokyo Women''s Medical University Yachiyo Medical Center, Chiba, Japan;4. Division of Pharmacy, Chiba University Hospital, Chiba, Japan;5. Division of Infectious Disease, Medical Mycology Research Center, Chiba University, Chiba, Japan;1. Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan;2. Department of Infectious Diseases and Infection Control, The Jikei University School of Medicine, Tokyo, Japan;1. Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan;2. Kyushu General Medicine Center, Haradoi Hospital, 6-40-8 Aoba, Higashi-ku, Fukuoka, 813-8588, Japan;1. Division of Laboratory Medicine, Sapporo Medical University Hospital, Japan;2. Department of Microbiology, Sapporo Medical University School of Medicine, Japan;3. Division of Infection Control, Sapporo Medical University Hospital, Japan;4. Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan |
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Abstract: | IntroductionAlthough peak C-reactive protein (CRP) levels are correlated with the prognosis of some diseases, there have been no reports regarding the association between peak CRP levels and mortality in patients with bacteremia. The present study aimed to determine the association between peak CRP levels and prognosis in patients with bacteremia.MethodsThis retrospective cohort study was conducted in a single tertiary hospital and included patients with bacteremia admitted to the emergency department from November 2012 to March 2017. Cox regression analysis was performed to examine the association between peak CRP levels and 30-day mortality. We also performed propensity score adjustment using potential confounding factors.ResultsOne hundred fifty-nine patients were included in the study. Peak CRP levels were significantly higher in the β-hemolytic streptococci (P = 0.001) and Streptococcus pneumoniae (P = 0.003) groups. The C-statistic of the multivariate logistic regression model for the propensity score was 0.88. For 30-day mortality, peak CRP levels >20 mg/dL did not show significance in the Cox regression analysis (hazard ratio, 0.866; 95% confidence interval, 0.489–1.537; P = 0.62). Even after propensity score adjustment, no significance was noted (hazard ratio, 0.865; 95% confidence interval, 0.399–1.876; P = 0.71).ConclusionsPeak CRP levels were not an independent predictor of mortality in patients with bacteremia in the emergency department. Clinicians should consider that patients with extremely high peak CRP levels do not necessarily have high mortality and vice versa. |
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Keywords: | Bacteremia C-reactive protein Peak CRP levels 30-Day mortality Emergency department Propensity score adjustment |
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