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C-reactive protein concentrations during bacteraemia: A comparison between patients with and without liver
Iain Mackenzie1, Joe Woodhouse
1John Farman Intensive Care Unit, Box 17, Addenbrooke's Hospital, CB2 2QQ, Cambridge, UK. iain@number2.demon.co.uk
Intensive Care Medicine
|June 27, 2006
Summary
Serum C-reactive protein (CRP) levels are lower in patients with liver dysfunction during bacteremia. Caution is advised when using CRP to diagnose sepsis in these patients.
Area of Science:
- Critical Care Medicine
- Clinical Biochemistry
- Infectious Diseases
Background:
- Serum C-reactive protein (CRP) is a common biomarker for inflammation and infection.
- Liver dysfunction can potentially affect CRP production and interpretation.
- Accurate sepsis diagnosis is crucial in intensive care settings.
Purpose of the Study:
- To assess the utility of serum CRP as a sepsis marker in patients with liver dysfunction.
- To compare CRP levels in patients with and without liver dysfunction during bacteremia.
Main Methods:
- Retrospective case-control study.
- Inclusion of patients with first episode of bacteremia from intensive care units.
- Defined liver dysfunction by prothrombin time and serum bilirubin levels.
Main Results:
- 126 episodes of bacteremia were analyzed; 33 involved patients with liver dysfunction.
- Serum CRP concentrations were significantly lower in patients with liver dysfunction (median 103 mg/l) compared to those without (median 146 mg/l).
Conclusions:
- Biochemical evidence of liver disease is associated with lower serum CRP concentrations during bacteremia.
- Serum CRP interpretation for sepsis diagnosis and monitoring requires caution in patients with liver disease.