C-reactive protein and albumin kinetics after antibiotic therapy in community- acquired bloodstream infection
International Journal of Infectious Diseases Apr 08, 2020
Póvoa P, Garvik OS, Vinholt PJ, et al. - Researchers conducted a population-based study assessing C-reactive protein (CRP) and plasma albumin (PA) kinetics to determine 1-year outcomes of community-acquired bloodstream infection (CA-BSI) patients. CRP and PA measurements were done on day 1 (D1) and D4 in 935 patients. Outcomes support the clinical utility of serial CRP measurements at D1 and D4 after CA-BSI to recognize patients with poor outcome. Individual patterns of CRP-ratio response with PA at D1 led to further improvement in the ability of predicting short or long-term mortality. At D4, lower CRP-ratio was reported in survivors on D365 vs D4-D30 non-survivors and D30-D365 non-survivors. Non-response and biphasic response patients had 2.74 and 5.29 increased risk, respectively, of death in D4-D30 and 2.77 and 3.16 increased risk, respectively, of death in D31-D365, when compared with fast response patients. Roughly unchanged PA levels were observed from D1-D4, but lower D1 PA was predictive of higher short and long-term mortality. The CRP-ratio and D1 PA had acceptable discriminative performance for recognition of patients with poor short and long-term mortality after adjustments.
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