Abstract
BackgroundPulmonary 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.MethodsWe 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.ResultsTwenty-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.ConclusionsCRP 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.
Highlights
Pulmonary exacerbation is one of the main risk factors for death in patients with cystic fibrosis
Analysis of the association between C-reactive protein (CRP) and baseline characteristics revealed higher CRP levels in patients colonized by P. aeruginosa (4.4 vs 2.2; p = 0.016), patients diagnosed with allergic bronchopulmonary aspergillosis (4.9 vs 2.9; p = 0.024), patients taking oral corticosteroids (6.1 vs 3.0; p = 0.010), and patients who had had a larger number of exacerbations treated with intravenous antibiotics during the previous year (p = 0.001)
We investigated the potential association between CRP level and the severity of pulmonary exacerbations requiring hospital admission in patients with cystic fibrosis and ascertained whether CRP level was associated with specific clinical characteristics
Summary
Pulmonary exacerbation is one of the main risk factors for death in patients with cystic fibrosis. 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. No validated scoring systems have been designed for early detection of a pulmonary exacerbation, the clinical picture, which is accompanied by a decrease in lung function parameters, is usually sufficient. Appropriate monitoring of these parameters in a specialized unit and follow-up are key elements for early diagnosis and initiation of suitable immediate therapy [15]
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