Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2012 |
| Outros Autores: | , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/36481 |
Resumo: | Centro Hospitalar de Lisboa Ocidental. Hospital de São Francisco Xavier. Polyvalent Intensive Care Unit. Lisbon, Portugal / New University of Lisbon. Centro de Estudos de Doenças Crónicas. Faculty of Medical Sciences. Lisbon, Portugal. |
| id |
CRUZ_e20f87f4b3bf44e3ca068a49147fd203 |
|---|---|
| oai_identifier_str |
oai:www.arca.fiocruz.br:icict/36481 |
| network_acronym_str |
CRUZ |
| network_name_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| repository_id_str |
2135 |
| spelling |
Coelho, Luís M.Salluh, Jorge I. F.Soares, MárcioBozza, Fernando A.Verdeal, Juan Carlos R.Castro-Faria-Neto, Hugo C.Silva, José Roberto Lapa eBozza, Patrícia T.Povoa, Pedro2019-10-16T12:33:53Z2019-10-16T12:33:53Z2012COELHO, Luís M. et al. Patterns of c-reactive protein RATIO response in severe community-acquired pneumonia: a cohort study. Critical Care, v.16, p. 1-8, 2012.1364-8535https://www.arca.fiocruz.br/handle/icict/3648110.1186/cc112911466-609XengBMCPatterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleCentro Hospitalar de Lisboa Ocidental. Hospital de São Francisco Xavier. Polyvalent Intensive Care Unit. Lisbon, Portugal / New University of Lisbon. Centro de Estudos de Doenças Crónicas. Faculty of Medical Sciences. Lisbon, Portugal.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Instituto Nacional de Câncer. Postgraduate Program. Rio de Janeiro, Brazil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Instituto Nacional de Câncer. Postgraduate Program. Rio de Janeiro, Brazil.Fundação Rio de Janeiro. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.Hospital Barra D’Or. Intensive Care Unit. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Pulmonary Diseases Department. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunofarmacologia. Rio de Janeiro, RJ, Brasil.Centro Hospitalar de Lisboa Ocidental. Hospital de São Francisco Xavier. Polyvalent Intensive Care Unit. Lisbon, Portugal / New University of Lisbon. Centro de Estudos de Doenças Crónicas. Faculty of Medical Sciences. Lisbon, Portugal.Introduction: Community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission remains a severe medical condition, presenting ICU mortality rates reaching 30%. The aim of this study was to assess the value of different patterns of C-reactive protein (CRP)-ratio response to antibiotic therapy in patients with severe CAP requiring ICU admission as an early maker of outcome. Methods: In total, 191 patients with severe CAP were prospectively included and CRP was sampled every other day from D1 to D7 of antibiotic prescription. CRP-ratio was calculated in relation to D1 CRP concentration. Patients were classified according to an individual pattern of CRP-ratio response with the following criteria: fast response - when D5 CRP was less than or equal to 0.4 of D1 CRP concentration; slow response - when D5 CRP was > 0.4 and D7 less than or equal to 0.8 of D1 CRP concentration; nonresponse - when D7 CRP was > 0.8 of D1 CRP concentration. Comparison between ICU survivors and non-survivors was performed. Results: CRP-ratio from D1 to D7 decreased faster in survivors than in non-survivors (p = 0.01). The ability of CRPratio by D5 to predict ICU outcome assessed by the area under the ROC curve was 0.73 (95% Confidence Interval, 0.64 - 0.82). By D5, a CRP concentration above 0.5 of the initial level was a marker of poor outcome (sensitivity 0.81, specificity 0.58, positive likelihood ratio 1.93, negative likelihood ratio 0.33). The time-dependent analysis of CRP-ratio of the three patterns (fast response n = 66; slow response n = 81; nonresponse n = 44) was significantly different between groups (p < 0.001). The ICU mortality rate was considerably different according to the patterns of CRP-ratio response: fast response 4.8%, slow response 17.3% and nonresponse 36.4% (p < 0.001). Conclusions: In severe CAP, sequential evaluation of CRP-ratio was useful in the early identification of patients with poor outcome. The evaluation of CRP-ratio pattern of response to antibiotics during the first week of therapy was useful in the recognition of the individual clinical evolution.Community-acquired pneumoniaC-reactive proteininfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/36481/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Coelho_Luís_etal_INI_2012.pdfve_Coelho_Luís_etal_INI_2012.pdfapplication/pdf294307https://www.arca.fiocruz.br/bitstream/icict/36481/2/ve_Coelho_Lu%c3%ads_etal_INI_2012.pdf05a16071390405bcdf3017a5cfbd474cMD52TEXTve_Coelho_Luís_etal_INI_2012.pdf.txtve_Coelho_Luís_etal_INI_2012.pdf.txtExtracted texttext/plain33838https://www.arca.fiocruz.br/bitstream/icict/36481/3/ve_Coelho_Lu%c3%ads_etal_INI_2012.pdf.txtdb4633f3ace9480e6935813ae59005d8MD53icict/364812022-06-24 13:02:48.942oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352022-06-24T16:02:48Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.pt_BR.fl_str_mv |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| title |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| spellingShingle |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study Coelho, Luís M. Community-acquired pneumonia C-reactive protein |
| title_short |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| title_full |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| title_fullStr |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| title_full_unstemmed |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| title_sort |
Patterns of C-reactive protein ratio response in severe community-acquired pneumonia: a cohort study |
| author |
Coelho, Luís M. |
| author_facet |
Coelho, Luís M. Salluh, Jorge I. F. Soares, Márcio Bozza, Fernando A. Verdeal, Juan Carlos R. Castro-Faria-Neto, Hugo C. Silva, José Roberto Lapa e Bozza, Patrícia T. Povoa, Pedro |
| author_role |
author |
| author2 |
Salluh, Jorge I. F. Soares, Márcio Bozza, Fernando A. Verdeal, Juan Carlos R. Castro-Faria-Neto, Hugo C. Silva, José Roberto Lapa e Bozza, Patrícia T. Povoa, Pedro |
| author2_role |
author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Coelho, Luís M. Salluh, Jorge I. F. Soares, Márcio Bozza, Fernando A. Verdeal, Juan Carlos R. Castro-Faria-Neto, Hugo C. Silva, José Roberto Lapa e Bozza, Patrícia T. Povoa, Pedro |
| dc.subject.en.pt_BR.fl_str_mv |
Community-acquired pneumonia C-reactive protein |
| topic |
Community-acquired pneumonia C-reactive protein |
| description |
Centro Hospitalar de Lisboa Ocidental. Hospital de São Francisco Xavier. Polyvalent Intensive Care Unit. Lisbon, Portugal / New University of Lisbon. Centro de Estudos de Doenças Crónicas. Faculty of Medical Sciences. Lisbon, Portugal. |
| publishDate |
2012 |
| dc.date.issued.fl_str_mv |
2012 |
| dc.date.accessioned.fl_str_mv |
2019-10-16T12:33:53Z |
| dc.date.available.fl_str_mv |
2019-10-16T12:33:53Z |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.citation.fl_str_mv |
COELHO, Luís M. et al. Patterns of c-reactive protein RATIO response in severe community-acquired pneumonia: a cohort study. Critical Care, v.16, p. 1-8, 2012. |
| dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/36481 |
| dc.identifier.issn.pt_BR.fl_str_mv |
1364-8535 |
| dc.identifier.doi.none.fl_str_mv |
10.1186/cc11291 |
| dc.identifier.eissn.none.fl_str_mv |
1466-609X |
| identifier_str_mv |
COELHO, Luís M. et al. Patterns of c-reactive protein RATIO response in severe community-acquired pneumonia: a cohort study. Critical Care, v.16, p. 1-8, 2012. 1364-8535 10.1186/cc11291 1466-609X |
| url |
https://www.arca.fiocruz.br/handle/icict/36481 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.publisher.none.fl_str_mv |
BMC |
| publisher.none.fl_str_mv |
BMC |
| dc.source.none.fl_str_mv |
reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
| instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
| instacron_str |
FIOCRUZ |
| institution |
FIOCRUZ |
| reponame_str |
Repositório Institucional da FIOCRUZ (ARCA) |
| collection |
Repositório Institucional da FIOCRUZ (ARCA) |
| bitstream.url.fl_str_mv |
https://www.arca.fiocruz.br/bitstream/icict/36481/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/36481/2/ve_Coelho_Lu%c3%ads_etal_INI_2012.pdf https://www.arca.fiocruz.br/bitstream/icict/36481/3/ve_Coelho_Lu%c3%ads_etal_INI_2012.pdf.txt |
| bitstream.checksum.fl_str_mv |
8a4605be74aa9ea9d79846c1fba20a33 05a16071390405bcdf3017a5cfbd474c db4633f3ace9480e6935813ae59005d8 |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ) |
| repository.mail.fl_str_mv |
repositorio.arca@fiocruz.br |
| _version_ |
1813009031015432192 |