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[C reactive protein as marker of infection among patients with severe closed trauma].

Abstract：

BACKGROUND:Injury and infection are characterized by the activation of the acute phase proteins response. C-reactive protein (CRP), an acute phase protein, has been mentioned as an useful indicator of infection and sepsis in critically ill patients. OBJECTIVE:To study the evolution of serum CRP in patients with severe blunt trauma and to ascertain its ability as a biological marker of infection during the first seven days after injury. METHODS:We prospectively studied 54 patients with blunt trauma (injury severity score>=16) age>14 years and length of the Intensive Care Unit (ICU) estay>= 7 days, over a 4-month period. Culture-proven infections were collected and serum CRP was determinated every day, during the first week after ICU admission. RESULTS:Twenty-eight patients (51.8%) developed an infection during the first week, and the median day of diagnosis of infection was day 6. Pneumonia was the most common infection (50%) and Gram-negative bacilli (63.3%) were the most common microorganisms recovered. Serum CRP levels were significantly higher in the infected patients group after day 4, showing a median value higher than 170 mg/l. Based on the receiver operating characteristic (ROC) curve analysis, a cutoff value of 109.5 mg/l for CRP gives a sensitivity of 78.6% and a specifity of 73.1% in predicting the presence of infection. CONCLUSIONS:The course of serum CRP levels is different in the group of patients with severe blunt trauma and infection, compared with the non-infected group during the first week after injury and it could be an useful supplementary marker for infection after postinjury day 4. A value of 110 mg/l or higher for CRP should suggest an underlying infectious complication.

journal_name

Enferm Infecc Microbiol Clin

journal_title

Enfermedades infecciosas y microbiologia clinica

authors

Flores JM,Jiménez PI,Rincón D,Márquez J,Navarro H,Muñoz A,Murillo F

subject

Has Abstract

pub_date

2001-02-01 00:00:00

pages

61-5

issue

2

eissn

0213-005X

issn

1578-1852

pii

S0213-005X(01)72562-1

journal_volume

19

pub_type

杂志文章

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