Supervisors info:
Κωνσταντίνος Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελένη Κυρίτση, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Δημήτριος Τούσουλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Backround: Biomarkers can add accuracy to any bacterial presence and are useful for monitoring the evolution of the infectious process. Troponin release is common during severe illness and is associated with increased morbidity, mortality, and length of stay in hospital. CRP is also a protein which is produced in response to infection and / or inflammation and is widely used in clinical trials to diagnose and manage patients with sepsis.
Purpose: The aim of the present study was to evaluate the prognostic value of serum C-reactive protein and serum high sensitivity troponin in patients with severe sepsis.
Methods: The sample consisted of 105 patients who were admitted due to infection to the 1st department of internal medicine of GNE Thriasio Hospital during the period 15/01/18 - 15/10/2018 . The data were collected from patients’ medical files and laboratory test results. The statistical analysis was performed with the statistical package SPSS-22 and the application of the statistical test t-test, anova and Pearson correlation. The statistical significance was set at p≤0.5 .
Results: Women accounted for 61,5% of the sample and moreover 58,6% of the patients were over the age of 76. The focus of infection in 36.5% concerned the urinary system and in 12.5% the outcome was death.
Abnormally high values of creatine kinase (CK) had observed in 80.8% of them, high sensitivity troponin T (hsCTNT) 74.4%, creatinine (Cr) 17.7% while all patients, 100% had abnormal CRP values. People aged over 76 years had higher qSOFA score values (p <0.001). The patients who died had a higher qSOFA score (p <0.001), higher values of creatine kinase CK (p = 0.001), troponin T hscTNT (p = 0.001), creatinine Cr (p = 0.04), but no difference in CRP levels. Furthermore, patients who suffered from chronic kidney disease performed greater Qsofa score (p=0,001) , had higher levels of serum creatine kinase CK (p <0.001), troponin T (p = 0.045), creatinine Cr (p <0.001) and a marginally statistically significant difference in C-reactive protein CRP (p = 0.078). Moreover the elevation of Qsofa score had a moderately positive correlation with creatine kinase CK (p = 0.009), T hscTN (p = 0.004), Cr (p = 0.007), age (p <0.001), and the presence of chronic kidney disease, (p <0.001).
Conclusion : The association of elevated troponin levels with the severity of sepsis was confirmed by both relevant research and this study, with the correlation of the CRP index being marginally statistically significant and in need of further investigation.
Keywords:
Sepsis, Prognosis , Biomarkers, Troponine , CRP
