High sensitive C-reactive protein for prediction of adverse outcome in acute exacerbation of chronic obstructive pulmonary disease

Abstract

Hospitalization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with a high risk of mortality and complications. The goal of the study is to assess the clinical utility of serum high sensitive C-reactive protein (hs-CRP) at admission in predicting outcome in hospitalized patients with AECOPD. Methods: Consecutive patients with AECOPD admitted to a public teaching hospital were studied prospectively. The adverse outcome defined occurrence of one or more of: (1) death in hospital or within 30 days after discharge, (2) transfer to the intensive care unit, or (3) intubation and mechanical ventilation. The correlation of hs-CRP with duration of hospitalization and FEV1% of predicted is also calculated. Results: Of 60 patients, 22 had adverse outcome and 38 good outcomes. There were no significant differences between two group for mean age, gender, smoking status, and previous hospitalizations (p>0.05). The adverse outcome rate was 56.5% in those with serum hs-CRP equal or more than 100 mg/ml versus 24.3% in patients with hs-CRP less 100 mg/ml (p=0.01). Conclusions: Serum hs-CRP at admission is a predictor of outcome in AECOPD. Admission hs-CRP higher than 100 mg/ml was associated with near fourfold increased probability of adverse outcome.