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Objectives: We investigated the relationship between the severity of pneumonia and the levels of acute phase proteins, such as C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR), at both the initial presentation and at the end of therapy.
Methods: One hundred and sixty patients were included in the study and these patients were classified into four groups according to the severity of pneumonia as recommended by the 2001 American Thoracic Society (ATS) and 2002 Turkish Thoracic Society (TTS) guidelines. The serum acute phase reactants (APR) and white blood cell (WBC) counts were measured upon admission as well as at the end of therapy. Patients underwent a posteroanterior and lateral chest radiograph on their day of admission and every three days thereafter. Complication was defined as the presence of pleural effusion, empyema and cavity.
Results: One hundred and sixty patients were included in the study. The mean age was 48.6+20.6 years; 97 patients (60.6%) were male and 63 patients (39.4%) female. Fifty-three patients had chronic disease, the most frequent being chronic obstructive pulmonary disease (14%) and diabetes mellitus (11%). Ten patients died during their hospital stay. On admission, all patients had elevated CRP levels. The severity of disease was associated with admission levels of CRP and WBCs, but not with ESR and fibrinogen. CRP levels were statistically higher in those patients who died than in those who survived.
Conclusions: CRP seems to be better suited for use in the monitoring of response to treatment and for estimating the risk of mortality and complications than the alternative APR.