Clinical usefulness of C-reactive protein versus shock index in predicting mortality in septic Critically Ill patients who are taking nor-epinephrine

Abstract EN

Objective : C-reactive protein (CRP) and shock index (SI) have been previously shown to identify high risk septic shock patients.Our objective was to compare the ability of SI and CRP to predict the primary outcome of overall 28-day mortality, and the secondary outcomes of early mortality (≤ 14 days), late mortality (>14 days) in septic critically ill patients who are taking norepinephrine as a vasopressor.

Methods : We performed a retrospective analysis of patientsadmitted to our adult ICU between April 2017 and Sep 2018 who were meet the inclusion criteria.

Independent T-test, Mann Whitney U test, and χ2 test were used to express all patient variables.A receiver operating characteristic (ROC) curve followed by sensitivity analysis was generated to determine the predictive performances, and the optimal cut-off values for CRP and SI.

The binary logistic regression model was used to generate CRP and SI predictive equations and correlation plots for early, late, and overall 28-day ICU mortality.

Results: A total of 163 critically ill patients were finally included in this study.

The mean overall age was 58.37±9.96 years, and 112 subjects (68.71 %) were male.

The early, late, and overall 28-day ICU mortality rate were9.82 %, 29.45 %, and 39.82 %, respectively.

SI and CRP were significantly higher in non-survivors (1.29±0.17 bpm/mmHg and 43.09±19.28 mg/dl, p < 0.05) than in survivors (1.12±0.03 bpm/mmHg, and 28.38±14.38 mg / dl).

Conclusion : SI is an effective, no-cost bedside modality, which is a realistic, reliable, and discriminative prognosticator with high sensitivity, specificity, performance, and accuracy when compared with CRP.