C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity

BACKGROUND: C-reactive protein (CRP) measurement has proven valuable for detecting exacerbations, but its usefulness in predicting etiology remains controversial. Likewise, its potential value as a marker of severity, which is well established in patients with pneumonia, remains unproven in chronic...

Descripción completa

Detalles Bibliográficos
Autores: Gallego, Miguel, Pomares, Xavier, Capilla, Silvia, Marcos, Ma. Angeles, Suárez, David, Monsó, Eduard, Monton, Concepción
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/103927
Acceso en línea:https://hdl.handle.net/2445/103927
Access Level:acceso abierto
Palabra clave:Malalties pulmonars obstructives cròniques
Virus
Chronic obstructive pulmonary diseases
Viruses
id ES_04472b4bed6c2dd20fcc37bbb03bb46a
oai_identifier_str oai:recercat.cat:2445/103927
network_acronym_str ES
network_name_str España
repository_id_str
spelling C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severityGallego, MiguelPomares, XavierCapilla, SilviaMarcos, Ma. AngelesSuárez, DavidMonsó, EduardMonton, ConcepciónMalalties pulmonars obstructives cròniquesVirusChronic obstructive pulmonary diseasesVirusesBACKGROUND: C-reactive protein (CRP) measurement has proven valuable for detecting exacerbations, but its usefulness in predicting etiology remains controversial. Likewise, its potential value as a marker of severity, which is well established in patients with pneumonia, remains unproven in chronic obstructive pulmonary disease (COPD) exacerbations. METHODS: A cohort study of 118 patients with severe COPD and acute infectious exacerbations were included and followed up over 1 year. Episodes of exacerbations meeting Anthonisen's criteria type I-II were evaluated, analyzing the etiology and inflammatory response as measured by CRP in blood. RESULTS: A total of 380 episodes were recorded. Full microbiological analysis was available in 265 samples. Haemophilus influenzae was the most commonly isolated bacteria and rhinovirus the most common virus. Median CRP levels from the 265 episodes were higher in the cases with positive cultures for bacteria (58.30 mg/L, interquartile range [IQR] 21.0-28.2) than in episodes only positive for viruses (37.3 mg/L, IQR 18.6-79.1) and cases negative for any microorganism (36.4 mg/L, IQR 10.8-93.7) (P<0.014). H. influenzae and Streptococcus pneumoniae reached the highest CRP levels of 74.5 mg/L (IQR 23.9-167.9) and 74.1 mg/L (IQR 42.0-220.7), respectively. In the 380 exacerbations studied, 227 (~60%) were community-managed, while 153 (~40%) required hospital admission. In the multivariate analysis to assess the influence of inflammatory response on exacerbation severity, baseline hypercapnia (odds ratio [OR]: 2.70, 95% confidence interval [CI]: 1.46-4.9) and CRP levels >100 mg/L (OR: 4.23, 95% CI: 2.12-8.44) were independent predictors after adjustment for baseline characteristics. CONCLUSION: CRP level was higher in bacterial infections, especially when H. influenzae and S. pneumoniae were isolated. CRP values >100 mg/L were associated with a fourfold increased risk of hospital admission. Therefore, CRP blood levels may be a useful biomarker in the management of exacerbations appearing in patients with severe disease.Dove Press2016201620162016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion8 p.application/pdfhttps://hdl.handle.net/2445/103927Articles publicats en revistes (ISGlobal)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: http://dx.doi.org/10.2147/COPD.S117129International Journal of Chronic Obstructive Pulmonary Disease, 2016, vol. 11, p. 2633-2640http://dx.doi.org/10.2147/COPD.S117129cc by-nc (c) Gallego et al., 2016http://creativecommons.org/licenses/by-nc/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1039272026-05-29T05:05:01Z
dc.title.none.fl_str_mv C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
title C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
spellingShingle C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
Gallego, Miguel
Malalties pulmonars obstructives cròniques
Virus
Chronic obstructive pulmonary diseases
Viruses
title_short C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
title_full C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
title_fullStr C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
title_full_unstemmed C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
title_sort C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity
dc.creator.none.fl_str_mv Gallego, Miguel
Pomares, Xavier
Capilla, Silvia
Marcos, Ma. Angeles
Suárez, David
Monsó, Eduard
Monton, Concepción
author Gallego, Miguel
author_facet Gallego, Miguel
Pomares, Xavier
Capilla, Silvia
Marcos, Ma. Angeles
Suárez, David
Monsó, Eduard
Monton, Concepción
author_role author
author2 Pomares, Xavier
Capilla, Silvia
Marcos, Ma. Angeles
Suárez, David
Monsó, Eduard
Monton, Concepción
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Malalties pulmonars obstructives cròniques
Virus
Chronic obstructive pulmonary diseases
Viruses
topic Malalties pulmonars obstructives cròniques
Virus
Chronic obstructive pulmonary diseases
Viruses
description BACKGROUND: C-reactive protein (CRP) measurement has proven valuable for detecting exacerbations, but its usefulness in predicting etiology remains controversial. Likewise, its potential value as a marker of severity, which is well established in patients with pneumonia, remains unproven in chronic obstructive pulmonary disease (COPD) exacerbations. METHODS: A cohort study of 118 patients with severe COPD and acute infectious exacerbations were included and followed up over 1 year. Episodes of exacerbations meeting Anthonisen's criteria type I-II were evaluated, analyzing the etiology and inflammatory response as measured by CRP in blood. RESULTS: A total of 380 episodes were recorded. Full microbiological analysis was available in 265 samples. Haemophilus influenzae was the most commonly isolated bacteria and rhinovirus the most common virus. Median CRP levels from the 265 episodes were higher in the cases with positive cultures for bacteria (58.30 mg/L, interquartile range [IQR] 21.0-28.2) than in episodes only positive for viruses (37.3 mg/L, IQR 18.6-79.1) and cases negative for any microorganism (36.4 mg/L, IQR 10.8-93.7) (P<0.014). H. influenzae and Streptococcus pneumoniae reached the highest CRP levels of 74.5 mg/L (IQR 23.9-167.9) and 74.1 mg/L (IQR 42.0-220.7), respectively. In the 380 exacerbations studied, 227 (~60%) were community-managed, while 153 (~40%) required hospital admission. In the multivariate analysis to assess the influence of inflammatory response on exacerbation severity, baseline hypercapnia (odds ratio [OR]: 2.70, 95% confidence interval [CI]: 1.46-4.9) and CRP levels >100 mg/L (OR: 4.23, 95% CI: 2.12-8.44) were independent predictors after adjustment for baseline characteristics. CONCLUSION: CRP level was higher in bacterial infections, especially when H. influenzae and S. pneumoniae were isolated. CRP values >100 mg/L were associated with a fourfold increased risk of hospital admission. Therefore, CRP blood levels may be a useful biomarker in the management of exacerbations appearing in patients with severe disease.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016
2016
2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/103927
url https://hdl.handle.net/2445/103927
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.2147/COPD.S117129
International Journal of Chronic Obstructive Pulmonary Disease, 2016, vol. 11, p. 2633-2640
http://dx.doi.org/10.2147/COPD.S117129
dc.rights.none.fl_str_mv cc by-nc (c) Gallego et al., 2016
http://creativecommons.org/licenses/by-nc/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc (c) Gallego et al., 2016
http://creativecommons.org/licenses/by-nc/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
application/pdf
dc.publisher.none.fl_str_mv Dove Press
publisher.none.fl_str_mv Dove Press
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869402782451105792
score 15,812455

Similares en LA Referencia