Diagnostic accuracy of c-reactive protein in immunocompromised patients with sepsis in intensive care units
Journal Title: National Journal of Physiology, Pharmacy and Pharmacology - Year 2015, Vol 5, Issue 3
Abstract
Background: It is very crucial to recognize infection in immunocompromised patients. Since CRP levels rise significantly 24 to 48 hours after the onset of inflammation it can be employed as a useful indicator of sepsis. Aims and Objective: To find out the diagnostic utility of CRP in immunocompromised patients with sepsis. Materials and Methods: This was a crosssectional study, which included immunocompromised patients with suspected sepsis. Patients were classified into two diagnostic groups: those with nonbacterial sepsis and those with bacterial sepsis, and the values of CRP were estimated. Results: Of 94 patients (63 men and 31 women) with a median age of 56 years (95% CI 53.9–59.3), 74 (78.5%) had immunosuppression with nonbacterial sepsis and 20 (21.4%) had immunosuppression with bacterial sepsis. CRP concentrations were higher in the group with bacterial sepsis [30.94 ng/ml (95% CI 25.13–36.74)] than those with nonbacterial sepsis [7.46 ng/ml (95% CI 7.05–7.87), P o 0.0001]. CRP concentrations that were 46 mg/L had 93.33% sensitivity but only 63.20% specificity for diagnosing sepsis. The accuracy of diagnosis was 87.23%. The area under the receiver-operating characteristic curve was 0.82 (0.72–0.92). Conclusion: Despite limited specificity in critically ill immunocompromised patients, CRP concentrations may help to rule out bacterial infection.
Authors and Affiliations
Manu S Menon, Simbita Marwah, Mihir Mehta, Arya D Dipak
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