Abstract

Introduction: In this study, the role of consecutive measurements of pneumonia symptom scores (PSS) and serum C-reactive protein (CRP) levels in predicting the time to clinical stability (TCS) of patients with community-acquired pneumonia (CAP) were investigated.

Material and Method: The hospitalized CAP patients were grouped according to CAP guidelines of the Turkish Thoracic Society (TTS). The clinical visits were made every day in order to define the TCS. Serum CRP levels and PSS were measured on admission and at the 3rd and 10th days of admission.

Results: Seventy seven patients with CAP (mean age 41.7 ± 24; 64 M/13F) were included in this study. According to TTS guidelines, patients were grouped as Group I-II (n=21), Group IIIA (n=26), Group IIIB (n=19) and Group IV (n=11). For the whole population, the mean TCS was 4±2.1 days. In patients with sepsis or whose antibiotic treatment had failed, a longer TCS was found by univariate analysis. The mean PSS measured on all days and serum CRP levels measured on the 3rd day of treatment were higher in patients with a TCS > 3 days (n=33) than those with a TCS ≤ 3 days (n=41) (p=0.045, p=0.005, p=0.001 and p=0.0001, respectively). The lack of CRP response at day 3 was found as a significant independent factor causing extension of TCS (OR: 3.32; 95% CI: 1.16-9.50; p=0.025).

Conclusion: The baseline PSS and CRP levels are not useful in predicting TCS, and the lack of CRP response on consecutive measurements is an independent factor affecting extension of the TCS in CAP patients