To correlate crp levels with curb65 score in mortality and outcome in patients of community acquired pneumonia

Background: Pneumonia is an infection of the pulmonary parenchyma. It can vary from inactive to eruptive in presentation and from mild to fatal in severity.Community-Acquired Pneumonia (CAP), is an important cause of morbidity and mortality worldwide.
Aims and objectives:To correlate C-reactive protein levels with curb 65 score in mortality and outcome of community acquired pneumonia .
Material and methods: the total of 60 patients were studied All the eligible patients with diagnosis of CAP who did no required hospitalisation were put on empirical antibiotic therapy and were followed on old basis. Patients admitted and The initial assessment included detailed history and clinical examination. Routine investigation at admission included complete blood count with ESR ,kidney function test ,liver function test,LDH, arterial blood gas analysis , chest roentgenogram, ECG, tho-racocentesis with analysis of pleural fluid (ph, total cell count , differential cell count , LDH , amy-lase ,gram staining and culture). Gram staining and culture of respiratory secretions and blood
culture were performed where ever feasable /indicated . A semi quantitative test for CRP was per-formed at admission and repeated at day 4. The CRP kit used was manufactured by Randox la-boratories ltd.with clinical assessment and initial lab investigations curb 65 score was calculated in all patients .
Result: Patients were examined for the signs which are directed in table 2.It was observed that CRP levels were significantly increased in 45% of patients. The raised cap levels in studied patients was associated with increased mortality and morbidity and crp was repeated by day4 and outcome was seen in patients whose crp failed to decrease by 50% or less
Conclusion: Crp is a reliable and sensitive marker for correlating with the severity of cap , length of stay and outcome.
CURB65 being a clinical score is adequate risk stratification model and is comparable to crp levels. Though crp levels >100mg/l are more sensitive in identifying the mortality in patients of cap.
Low crp levels <100mg/l effectively excludes severe community acquired pneumonia and can be used to clinical judgement to identify low risk patients who may be safely discharged ,as crp <100mg/l provides a high negative predictive value comparable to CURB65.