Patient selection: adult (>= 18 years of age) with community-acquired sepsis
Parameters:
(1) C-reactive protein (CRP) concentration on the day of ICU admission (Day 1) in mg/dL
(2) C-reactive protein concentration on Day 3 in mg/dL
(3) C-reactive protein concentration on Day 5 in mg/dL
(4) trend of change in the SOFA score
CRP ratio =
= (CRP on Day 5) / (CRP on Day 1)
|
CRP ratio
|
Type of Response
|
Hospital Mortality
|
|
< 0.40
|
fast
|
23%
|
|
0.40 to 0.80
|
slow
|
30%
|
|
> 0.80
|
no
|
41%
|
where:
• The fall in CRP upon resolution of an inflammatory stimulus tends to follow first-order kinetics.
• A hidden assumption is that the patient would have a normal CRP if not septic. This may not be true in a patient with an active autoimmune disease.
Features of a patient with a better prognosis:
(1) fast response pattern
(2) decrease in CRP on Day 3 compared to CRP on Day 1
(3) downward trend in SOFA score
