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Updated: Dec 8, 2025
Experimental Model to Evaluate Resolution of Pneumonia
Published on: February 17, 2023
The prognostic value of C-reactive protein for children with pneumonia
Yuval Barak-Corren1,2, Yair Horovits1,2, Matti Erlichman1,2
1Pediatric Department, Shaare Zedek Medical Center, Jerusalem, Israel.
Insights
C-reactive protein (CRP) effectively predicts pneumonia complications in children, aiding pediatricians in identifying high-risk patients for closer monitoring and improved outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Biochemistry
- Infectious Diseases
Background:
- Pneumonia is a common pediatric illness with potential for serious complications.
- Accurate prognostic markers are crucial for timely and appropriate patient management.
- C-reactive protein (CRP) is an inflammatory marker with potential prognostic value in pediatric pneumonia.
Purpose of the Study:
- To evaluate the prognostic significance of C-reactive protein (CRP) levels.
- To assess CRP's ability to predict pneumonia-associated complications in children.
- To determine if CRP can aid in identifying children requiring closer follow-up.
Main Methods:
- Retrospective cohort analysis of pediatric emergency department visits for pneumonia.
- Inclusion criteria: discharge diagnosis of pneumonia, CRP measurement available, and non-viral pneumonia.
- Outcomes assessed: hospitalization, parapneumonic effusion (PPE), chest drain placement, PICU admission, and bacteremia. Multivariate modeling and k-fold cross-validation were used.
Main Results:
- Analysis included 810 pediatric pneumonia visits; 38.8% resulted in hospitalization, 2.2% in PICU admission.
- 15.2% of cases developed parapneumonic effusion (PPE), with 28% requiring chest drain placement.
- Elevated CRP levels showed a statistically significant association with all studied outcomes (P < .001).
Conclusions:
- C-reactive protein (CRP) demonstrates significant prognostic value in pediatric pneumonia.
- CRP can assist pediatricians in identifying patients at higher risk for complications.
- Utilizing CRP may facilitate more targeted follow-up strategies for children with pneumonia.
Aim:
To measure the prognostic value of C-reactive protein (CRP) and its ability to predict pneumonia-associated complications.
Methods:
A 3.75-years retrospective cohort analysis of all paediatric emergency department visits with a discharge diagnosis of pneumonia. Visits where CRP was not measured or with a discharge diagnosis of viral pneumonia were excluded. The following five outcomes were studied: hospitalisation, presence of parapneumonic effusion (PPE), placement of a chest drain, admission to paediatric intensive care unit (PICU) and bacteremia. A multivariate model was constructed and validated using k-fold cross-validation.
Results:
During the study time period, there were 2561 visits for pneumonia, of which 810 were included in our analysis. The median age of included children was 3.2 years (range 0.2-17.7). Overall, 38.8% visits ended in hospitalisation, 2.2% required admission to PICU, 15.2% were complicated by a PPE of which 28% required the placement of a chest drain. Statistically significant association was found between CRP levels and each of these outcomes (P < .001). Incorporating CRP within a multivariate prediction model provided an area under the curve of up to 0.96.
Conclusion:
CRP can be a useful prognostic marker when evaluating a patient with suspected bacterial pneumonia and could help the paediatrician in identifying patients needing closer follow-up.
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