Baseline C-reactive protein level as a predictor of mortality in bacteraemia patients: a population-based cohort study.
Clin Microbiol Infect. 2010 Jun 8;
Authors: Gradel KO, Thomsen RW, Lundbye-Christensen S, Nielsen H, SchÃ¸nheyder HC
ABSTRACT We examined the association between CRP level at time of blood culture (BC) draw and mortality following bacteraemia. Our population-based cohort study comprised all first-time mono-microbial bacteraemia episodes in adults in a Danish county during 1996-2004 (n = 5,267). CRP was measured 24 h within the first positive BC draw. Cox's regression was used to compute mortality rate ratios (MRR) associated with CRP level quartiles (10-64 [reference], 65-143, 144-240, and 241-688 mg/L), controlling for age, gender, comorbidity, specialty, acquisition of infection, and infection focus. We also investigated for a biological interaction between CRP level and high magnitude of bacteraemia (3 of 3 culture bottles positive). 30-day mortality increased with higher CRP level: adjusted 0-30 day MRR for patients in the 2nd, 3rd, and 4th CRP quartile were 1.38 (95% confidence intervals, 1.13-1.69), 1.70 (1.40-2.06), and 2.38 (1.96-2.87), respectively (P for trend <10(-4)). In contrast, mortality associations with CRP during 31-365 days' follow-up were weak (adjusted MRR for 2nd-4th quartile ranged from 1.18 to 1.28). A high magnitude of bacteraemia strengthened the association between high CRP level and 30-day mortality. We conclude that the CRP level, measured concurrently with the first positive BC, independently predicted 30-day mortality in adult bacteraemia patients.
PMID: 20545964 [PubMed - as supplied by publisher]