C-reactive protein predicts mortality on admission to a surgical high-dependency unit

Introduction

C-reactive protein (CRP) is a non-specific marker that may be used to assess the magnitude of the inflammatory response in critically ill surgical patients. Our aim was to determine the temporal relationship between CRP measurement and mortality.

Methods

In a prospective study conducted in a surgical high-dependency unit (HDU), 132 consecutive patients were evaluated. Regional Ethics Committee approval was obtained. Serum CRP was measured on admission, day 1 and day 2 and was evaluated with respect to inhospital mortality.

Results

CRP on admission to HDU discriminated survivors from nonsurvivors (P < 0.0001, analysis of variance). A CRP greater than 100 mg/l correlated very strongly with mortality. The mortality in patients with a CRP less than 100 mg/l (n = 93) was 2.2%. The mortality in patients with a CRP greater than 100 mg/l (n = 39) was 25.6% (P < 0.0001, chi-square test), (Table 1). However, there were no significant differences in CRP with respect to mortality on day 1 or day 2 (P = 0.136 and 0.236, respectively).

Table 1 abstract P7

Conclusion

CRP on admission to the surgical HDU is a powerful predictor of mortality (P < 0.0001), but this correlation does not persist after the initial measurement. Our data suggest that early CRP measurement should be undertaken in all critically ill surgical patients in order to quantify the ultimate magnitude of the inflammatory response and the associated mortality.