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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
Objective:
To evaluate the value of serum C-reactive protein (CRP) concentrations as a marker of sepsis in patients with biochemical evidence of liver dysfunction.
Design:
A retrospective case-control comparison of serum CRP concentrations between patients with and those without liver dysfunction (prothrombin time over 18 s and serum bilirubin > or = 20 micromol/l) during their first episode of bacteraemia.
Setting:
The neurosciences and general adult intensive care units of a university teaching hospital.
Patients:
Any patient from the above settings with a first episode of bacteraemia (first isolate of pathogenic bacteria from blood cultures) over a 3-year period.
Measurements And Results:
After exclusions 126 first episodes of bacteraemia were identified, of which 33 were in patients with liver dysfunction. Serum CRP concentrations were significantly lower in patients with liver dysfunction (median 103 mg/l, IQR 29-204) than in those without (146 mg/l, 74, > 250).
Conclusions:
Patients with biochemical evidence of liver disease generate significantly lower serum CRP concentrations during bacteraemia than patients without liver dysfunction. Serum CRP concentrations should be interpreted with caution in patients with liver disease to diagnose and monitor bacterial sepsis.
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