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

# metadata.dc.description.abstract[].value
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.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.2147/COPD.S117129

# metadata.dc.relation.ispartof[].value
International Journal of Chronic Obstructive Pulmonary Disease,
                2016, vol. 11, p. 2633-2640

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
C-reactive protein in outpatients with acute exacerbation of
                COPD: its relationship with microbial etiology and severity