Role of C-reactive protein as a biomarker for prediction of the severity of pulmonary exacerbations in patients with cystic fibrosis

• Published in: BMC pulmonary medicine Vol. 14; no. 1; p. 150
• Main Authors: Girón-Moreno, Rosa Maria, Justicia, José L, Yamamoto, Sara, Valenzuela, Claudia, Cisneros, Carolina, Gómez-Punter, Rosa Mar, Fernandes-Vasconcelos, Gilda, Ancochea, Julio
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23-09-2014; BioMed Central
• Subjects: Adolescent; Adrenal Cortex Hormones - therapeutic use; Adult; Analysis; Anti-Bacterial Agents - therapeutic use; Aspergillosis, Allergic Bronchopulmonary - blood; Aspergillosis, Allergic Bronchopulmonary - complications; Biomarkers - blood; C-reactive protein; C-Reactive Protein - metabolism; Care and treatment; Cystic fibrosis; Cystic Fibrosis - blood; Cystic Fibrosis - complications; Cystic Fibrosis - drug therapy; Disease Progression; Female; Forced Expiratory Volume; Hospital patients; Hospitalization; Humans; Male; Measurement; Middle Aged; Patient outcomes; Pseudomonas aeruginosa; Pseudomonas Infections - blood; Pseudomonas Infections - complications; Severity of Illness Index; Young Adult
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/1471-2466-14-150

Pulmonary exacerbation is one of the main risk factors for death in patients with cystic fibrosis. Several biomarkers have proven useful in the diagnosis and treatment of pulmonary exacerbations, although none has been associated with severity. The objective of the present study was to investigate whether C-reactive protein (CRP) level was associated with the severity of pulmonary exacerbation requiring admission to hospital in patients with cystic fibrosis.
We designed a severity index for exacerbations based on 4 clinical parameters and determined whether there was an association between CRP levels and severity of the exacerbation. We also investigated the association between CRP and baseline functional and clinical variables.
Twenty-seven patients with cystic fibrosis required 62 admissions to hospital. CRP levels were not significantly associated with the severity index, although they were associated with specific patient characteristics: colonization by Pseudomonas aeruginosa, allergic bronchopulmonary aspergillosis, treatment with oral corticosteroids, and number of severe exacerbations treated with intravenous antibiotics during the previous year.
CRP level is not associated with the severity of pulmonary exacerbations, but it is associated with specific clinical characteristics. This simple scoring system (severity index) could prove very useful for evaluating the severity of exacerbations.