C-reactive protein as a prognostic factor for mortality in pneumonia patients with liver cirrhosis

C-reactive protein (CRP) is considered a useful predictor of mortality from community- acquired pneumonia (CAP). Serum CRP concentration reflects its production in the liver, and impaired liver function may affect CRP level. The purpose of this study was to evaluate whether the initial CRP level is a prognostic factor for mortality from CAP in patients with liver cirrhosis (LC).

CAP patients with LC admitted to two tertiary referral hospitals from January 2005 to June 2009 were included in this study. The associations between the initial clinical findings including CRP level and mortality were analyzed.

Sixty-one men and 15 women were included. Seventeen patients (22.4%) died while in the hospital. Univariate analysis showed that an initial CRP level above the median value of 6.93 mg/dL was related to a lower risk of mortality (P=0.048). Multivariate Cox regression analysis showed that the significance of the relationship between the initial CRP level and mortality risk in CAP patients with LC was sustained after adjusting for the CURB-65 score, presence of malignancy, MELD score, and underlying lung condition.

Higher initial serum CRP level is associated with lower mortality risk in CAP patients with LC.