Serial C-Reactive Protein Measurements for Prognostication and Antimicrobial Decision-Making in ICU Sepsis Patients:...

Area of Science:

• Critical Care Medicine
• Biomarker Research
• Sepsis Management

Background:

• C-reactive protein (CRP) is a common sepsis biomarker.
• Its prognostic value in intensive care unit (ICU) patients with sepsis is uncertain.
• This study investigates serial CRP measurements for predicting sepsis mortality.

Purpose of the Study:

• To evaluate the association between serial C-reactive protein (CRP) measurements and 90-day mortality in ICU patients with sepsis.
• To assess the prognostic value of CRP in sepsis management.
• To compare CRP's predictive performance with procalcitonin.

Main Methods:

• Retrospective cohort study of 171 adult ICU patients with sepsis (2020-2023).
• Included patients with at least three serial CRP measurements (days 1, 3, 7).
• Examined the relationship between CRP levels and 90-day mortality using logistic regression and ROC analysis.

Main Results:

• Day-1 CRP levels and temporal changes showed poor prediction for 90-day mortality (AUC=0.590).
• Non-survivors had slightly higher day-1 CRP (91 mg/L vs. 70 mg/L, p=0.08).
• Day-1 procalcitonin showed slightly better prediction (AUC=0.658); day-1 CRP was not associated with mortality in multivariable analysis.

Conclusions:

• Serial CRP measurements did not reliably predict mortality in ICU sepsis patients.
• CRP monitoring may influence antibiotic duration but has limited prognostic value.
• Routine CRP monitoring in ICU sepsis patients may not be beneficial for predicting outcomes.