Dipòsit Digital de la Universitat de Barcelona: C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity

<!DOCTYPE html> <html> <head> <title>Dipòsit Digital de la Universitat de Barcelona: C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity</title> <base href="https://diposit.ub.edu" /> <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" /> <meta name="Generator" content="DSpace 5.8" /> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <link rel="shortcut icon" href="/dspace/favicon.ico" type="image/x-icon"/> <link rel="stylesheet" href="/dspace/static/css/jquery-ui-1.10.3.custom/redmond/jquery-ui-1.10.3.custom.css" type="text/css" /> <link rel="stylesheet" href="/dspace/static/css/bootstrap/bootstrap.min.css" type="text/css" /> <link rel="stylesheet" href="/dspace/static/css/bootstrap/bootstrap-theme.min.css" type="text/css" /> <link rel="stylesheet" href="/dspace/static/css/bootstrap/dspace-theme.css" type="text/css" /> <link rel="search" type="application/opensearchdescription+xml" href="/dspace/open-search/description.xml" title="DSpace"/> <link rel="schema.DCTERMS" href="http://purl.org/dc/terms/" /> <link rel="schema.DC" href="http://purl.org/dc/elements/1.1/" /> <meta name="DC.creator" content="Gallego, Miguel" /> <meta name="DC.creator" content="Pomares, Xavier" /> <meta name="DC.creator" content="Capilla, Silvia" /> <meta name="DC.creator" content="Marcos, Ma. Angeles" /> <meta name="DC.creator" content="Su谩rez, David" /> <meta name="DC.creator" content="Mons贸, Eduard" /> <meta name="DC.creator" content="Monton, Concepci贸n" /> <meta name="DCTERMS.dateAccepted" content="2016-11-18T12:25:35Z" scheme="DCTERMS.W3CDTF" /> <meta name="DCTERMS.available" content="2016-11-18T12:25:35Z" scheme="DCTERMS.W3CDTF" /> <meta name="DCTERMS.issued" content="2016-01-21" scheme="DCTERMS.W3CDTF" /> <meta name="DC.identifier" content="1176-9106" /> <meta name="DC.identifier" content="https://hdl.handle.net/2445/103927" scheme="DCTERMS.URI" /> <meta name="DCTERMS.abstract" content="BACKGROUND: C-reactive protein (CRP) measurement has proven
 valuable for detecting exacerbations, but its usefulness in
 predicting etiology remains controversial. Likewise, its
 potential value as a marker of severity, which is well
 established in patients with pneumonia, remains unproven in
 chronic obstructive pulmonary disease (COPD) exacerbations.
 METHODS: A cohort study of 118 patients with severe COPD and
 acute infectious exacerbations were included and followed up
 over 1 year. Episodes of exacerbations meeting Anthonisen's
 criteria type I-II were evaluated, analyzing the etiology and
 inflammatory response as measured by CRP in blood. RESULTS: A
 total of 380 episodes were recorded. Full microbiological
 analysis was available in 265 samples. Haemophilus influenzae
 was the most commonly isolated bacteria and rhinovirus the most
 common virus. Median CRP levels from the 265 episodes were
 higher in the cases with positive cultures for bacteria (58.30
 mg/L, interquartile range [IQR] 21.0-28.2) than in episodes only
 positive for viruses (37.3 mg/L, IQR 18.6-79.1) and cases
 negative for any microorganism (36.4 mg/L, IQR 10.8-93.7)
 (P<0.014). H. influenzae and Streptococcus pneumoniae reached
 the highest CRP levels of 74.5 mg/L (IQR 23.9-167.9) and 74.1
 mg/L (IQR 42.0-220.7), respectively. In the 380 exacerbations
 studied, 227 (~60%) were community-managed, while 153 (~40%)
 required hospital admission. In the multivariate analysis to
 assess the influence of inflammatory response on exacerbation
 severity, baseline hypercapnia (odds ratio [OR]: 2.70, 95%
 confidence interval [CI]: 1.46-4.9) and CRP levels >100 mg/L
 (OR: 4.23, 95% CI: 2.12-8.44) were independent predictors after
 adjustment for baseline characteristics. CONCLUSION: CRP level
 was higher in bacterial infections, especially when H.
 influenzae and S. pneumoniae were isolated. CRP values >100
 mg/L were associated with a fourfold increased risk of hospital
 admission. Therefore, CRP blood levels may be a useful biomarker
 in the management of exacerbations appearing in patients with
 severe disease." /> <meta name="DCTERMS.extent" content="8 p." /> <meta name="DC.format" content="application/pdf" /> <meta name="DC.language" content="eng" scheme="DCTERMS.RFC1766" /> <meta name="DC.publisher" content="Dove Press" /> <meta name="DCTERMS.isFormatOf" content="Reproducci贸 del document publicat a:
 http://dx.doi.org/10.2147/COPD.S117129" /> <meta name="DCTERMS.isPartOf" content="International Journal of Chronic Obstructive Pulmonary Disease,
 2016, vol. 11, p. 2633-2640" /> <meta name="DC.relation" content="http://dx.doi.org/10.2147/COPD.S117129" scheme="DCTERMS.URI" /> <meta name="DC.rights" content="cc by-nc (c) Gallego et al., 2016" /> <meta name="DC.rights" content="http://creativecommons.org/licenses/by-nc/3.0/es/" scheme="DCTERMS.URI" /> <meta name="DC.source" content="Articles publicats en revistes (ISGlobal)" /> <meta name="DC.subject" content="Malalties pulmonars obstructives cr貌niques" /> <meta name="DC.subject" content="Virus" /> <meta name="DC.subject" content="Chronic obstructive pulmonary diseases" /> <meta name="DC.subject" content="Viruses" /> <meta name="DC.title" content="C-reactive protein in outpatients with acute exacerbation of
 COPD: its relationship with microbial etiology and severity" /> <meta name="DC.type" content="info:eu-repo/semantics/article" /> <meta name="DC.type" content="info:eu-repo/semantics/publishedVersion" /> <meta name="DC.date" content="2016-11-16T19:01:18Z" scheme="DCTERMS.W3CDTF" /> <meta name="DC.rights" content="info:eu-repo/semantics/openAccess" /> <meta name="DC.identifier" content="27799762" /> <meta name="citation_keywords" content="info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion" /> <meta name="citation_title" content="C-reactive protein in outpatients with acute exacerbation of
 COPD: its relationship with microbial etiology and severity" /> <meta name="citation_issn" content="1176-9106" /> <meta name="citation_publisher" content="Dove Press" /> <meta name="citation_language" content="eng" /> <meta name="citation_author" content="Gallego, Miguel" /> <meta name="citation_author" content="Pomares, Xavier" /> <meta name="citation_author" content="Capilla, Silvia" /> <meta name="citation_author" content="Marcos, Ma. Angeles" /> <meta name="citation_author" content="Su谩rez, David" /> <meta name="citation_author" content="Mons贸, Eduard" /> <meta name="citation_author" content="Monton, Concepci贸n" /> <meta name="citation_pdf_url" content="https://diposit.ub.edu/dspace/bitstream/2445/103927/1/gallego2016_2286.pdf" /> <meta name="citation_date" content="2016-01-21" /> <meta name="citation_abstract_html_url" content="https://diposit.ub.edu/dspace/handle/2445/103927" /> <script type='text/javascript' src="/dspace/static/js/jquery/jquery-1.10.2.min.js"></script> <script type='text/javascript' src='/dspace/static/js/jquery/jquery-ui-1.10.3.custom.min.js'></script> <script type='text/javascript' src='/dspace/static/js/bootstrap/bootstrap.min.js'></script> <script type='text/javascript' src='/dspace/static/js/holder.js'></script> <script type="text/javascript" src="/dspace/utils.js"></script> <script type="text/javascript" src="/dspace/static/js/choice-support.js"> </script>  <script async src="https://www.googletagmanager.com/gtag/js?id=G-TTP469ZDVB"></script> <script> window.dataLayer = window.dataLayer || []; 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                COPD: its relationship with microbial etiology and severity</td></tr> <tr><td class="metadataFieldLabel">Author: </td><td class="metadataFieldValue"><a class="author"href="/dspace/browse?type=author&value=Gallego%2C+Miguel">Gallego, Miguel</a><br /><a class="author"href="/dspace/browse?type=author&value=Pomares%2C+Xavier">Pomares, Xavier</a><br /><a class="author"href="/dspace/browse?type=author&value=Capilla%2C+Silvia">Capilla, Silvia</a><br /><a class="author"href="/dspace/browse?type=author&value=Marcos%2C+Ma.+Angeles">Marcos, Ma. Angeles</a><br /><a class="author"href="/dspace/browse?type=author&value=Su%C3%A1rez%2C+David">Su谩rez, David</a><br /><a class="author"href="/dspace/browse?type=author&value=Mons%C3%B3%2C+Eduard">Mons贸, Eduard</a><br /><a class="author"href="/dspace/browse?type=author&value=Monton%2C+Concepci%C3%B3n">Monton, Concepci贸n</a></td></tr> <tr><td class="metadataFieldLabel">Keywords: </td><td class="metadataFieldValue">Malalties pulmonars obstructives cr貌niques<br />Virus<br />Chronic obstructive pulmonary diseases<br />Viruses</td></tr> <tr><td class="metadataFieldLabel">Issue Date: </td><td class="metadataFieldValue">21-Jan-2016</td></tr> <tr><td class="metadataFieldLabel">Publisher: </td><td class="metadataFieldValue">Dove Press</td></tr> <tr><td class="metadataFieldLabel">Abstract: </td><td class="metadataFieldValue">BACKGROUND: C-reactive protein (CRP) measurement has proven
                valuable for detecting exacerbations, but its usefulness in
                predicting etiology remains controversial. Likewise, its
                potential value as a marker of severity, which is well
                established in patients with pneumonia, remains unproven in
                chronic obstructive pulmonary disease (COPD) exacerbations.
                METHODS: A cohort study of 118 patients with severe COPD and
                acute infectious exacerbations were included and followed up
                over 1 year. Episodes of exacerbations meeting Anthonisen's
                criteria type I-II were evaluated, analyzing the etiology and
                inflammatory response as measured by CRP in blood. RESULTS: A
                total of 380 episodes were recorded. Full microbiological
                analysis was available in 265 samples. Haemophilus influenzae
                was the most commonly isolated bacteria and rhinovirus the most
                common virus. Median CRP levels from the 265 episodes were
                higher in the cases with positive cultures for bacteria (58.30
                mg/L, interquartile range [IQR] 21.0-28.2) than in episodes only
                positive for viruses (37.3 mg/L, IQR 18.6-79.1) and cases
                negative for any microorganism (36.4 mg/L, IQR 10.8-93.7)
                (P<0.014). H. influenzae and Streptococcus pneumoniae reached
                the highest CRP levels of 74.5 mg/L (IQR 23.9-167.9) and 74.1
                mg/L (IQR 42.0-220.7), respectively. In the 380 exacerbations
                studied, 227 (~60%) were community-managed, while 153 (~40%)
                required hospital admission. In the multivariate analysis to
                assess the influence of inflammatory response on exacerbation
                severity, baseline hypercapnia (odds ratio [OR]: 2.70, 95%
                confidence interval [CI]: 1.46-4.9) and CRP levels >100 mg/L
                (OR: 4.23, 95% CI: 2.12-8.44) were independent predictors after
                adjustment for baseline characteristics. CONCLUSION: CRP level
                was higher in bacterial infections, especially when H.
                influenzae and S. pneumoniae were isolated. CRP values >100
                mg/L were associated with a fourfold increased risk of hospital
                admission. Therefore, CRP blood levels may be a useful biomarker
                in the management of exacerbations appearing in patients with
                severe disease.</td></tr> <tr><td class="metadataFieldLabel">Note: </td><td class="metadataFieldValue">Reproducci贸 del document publicat a:
                http://dx.doi.org/10.2147/COPD.S117129</td></tr> <tr><td class="metadataFieldLabel">It is part of: </td><td class="metadataFieldValue">International Journal of Chronic Obstructive Pulmonary Disease,
                2016, vol. 11, p. 2633-2640</td></tr> <tr><td class="metadataFieldLabel">URI: </td><td class="metadataFieldValue"><a href="https://hdl.handle.net/2445/103927">https://hdl.handle.net/2445/103927</a></td></tr> <tr><td class="metadataFieldLabel">Related resource: </td><td class="metadataFieldValue"><a href="http://dx.doi.org/10.2147/COPD.S117129">http://dx.doi.org/10.2147/COPD.S117129</a></td></tr> <tr><td class="metadataFieldLabel">ISSN: </td><td class="metadataFieldValue">1176-9106</td></tr> <tr><td class="metadataFieldLabel">Appears in Collections:</td><td class="metadataFieldValue"><a href="/dspace/handle/2445/55586">Articles publicats en revistes (ISGlobal)</a><br/><a href="/dspace/handle/2445/7212">Articles publicats en revistes (Fonaments Cl铆nics)</a><br/></td></tr> </table><br/> <div class="panel panel-info"><div class="panel-heading">Files in This Item:</div> <table class="table panel-body"><tr><th id="t1" class="standard">File</th> <th id="t2" class="standard">Description</th> <th id="t3" class="standard">Size</th><th id="t4" class="standard">Format</th><th> </th></tr> <tr><td headers="t1" class="standard"><a target="_blank" href="/dspace/bitstream/2445/103927/1/gallego2016_2286.pdf">gallego2016_2286.pdf</a></td><td headers="t2" class="standard"></td><td headers="t3" class="standard">850.39 kB</td><td headers="t4" class="standard">Adobe PDF</td><td class="standard" align="center"><a class="btn btn-primary" target="_blank" href="/dspace/bitstream/2445/103927/1/gallego2016_2286.pdf">View/Open</a></td></tr></table> </div> <div class="container row"> <a class="btn btn-default" href="/dspace/handle/2445/103927?mode=full"> Show full item record </a> </div> <br/> <br/> <p class="submitFormHelp alert alert-info"> This item is licensed under a <a rel="license" href="http://creativecommons.org/licenses/by-nc/3.0/es/">Creative Commons License</a> <a rel="license" href="http://creativecommons.org/licenses/by-nc/3.0/es/"><img src="/dspace/image/by-nc.png" width=100 border="0" alt="Creative Commons" /></a>   </p> <div class="addthis_sharing_toolbox"></div> </div> </main> <footer class="navbar navbar-inverse navbar-bottom" style='background:-webkit-linear-gradient(#6685a9,#406086);background:-o-linear-gradient(#6685a9,#406086);background:-moz-linear-gradient(#6685a9,#406086);background:linear-gradient(#6685a9,#406086);border-radius:0;border:0;width:100%'> <div id="designedby" class="container text-muted">  <div id="footer_feedback" class="pull-left"> <p class="text-muted"> <span style='color:white'>Coordination: </span> <a style='color:#000' onMouseOver="this.style.color='#fff'" onMouseOut="this.style.color='#000'" target='_blank' href='http://crai.ub.edu/en'> CRAI Universitat de Barcelona</a>       <a style='color:#000' onMouseOver="this.style.color='#fff'" onMouseOut="this.style.color='#000'" target="_blank" href='http://www.ub.edu/web/ub/en/menu_peu/avislegal/avis_legal.html'>Legal notice</a> </p> </div> <div id="footer_feedback" class="pull-right"> <p class="text-muted"> <span style='color:white'>Metadata subject to: </span> <a target='_blank' href='http://creativecommons.org/publicdomain/zero/1.0/'> <img src="/dspace/image/logoCC.png" alt="Logo CC" /> </a>      <span style='color:white'>Powered by: </span> <a style='color:#000' onMouseOver="this.style.color='#fff'" onMouseOut="this.style.color='#000'" target="_blank" href="http://dspace.org/">DSpace</a>      <a style='color:#000' onMouseOver="this.style.color='#fff'" onMouseOut="this.style.color='#000'" target="_blank" href="/dspace/feedback">Contact us</a> </p> </div>  </div> </footer> </body> </html>

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Dipòsit Digital de la Universitat de Barcelona: C-reactive protein in outpatients with acute exacerbation of COPD: its relationship with microbial etiology and severity