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Acil Servise Başvuran Geriatrik Hastaların CRP Düzeyi ile Hastaneye Yatış, Taburculuk, Yeniden Başvuru, Mortalite Oranları Arasındaki İlişki

Yıl 2025, Cilt: 8 Sayı: 1, 25 - 30, 29.03.2025
https://doi.org/10.54996/anatolianjem.1497523

Öz

Amaç: Bu çalışma, travmatik olmayan sebeplerle acil servise başvuran 65 yaş ve üzeri geriatrik hastalarda C-reaktif protein (CRP) düzeyleri ile hastaneye yatış, taburculuk, yeniden başvuru ve mortalite gibi sonuçlar arasındaki ilişkiyi araştırmayı amaçlamaktadır.

Gereç ve Yöntemler: 1 Ocak 2023 ile 30 Haziran 2023 tarihleri arasında, travmatik olmayan sebeplerle bir ikinci basamak devlet hastanesi acil servisine başvuran 65 yaş üstü hastalardan rutin tanı ve tedavi süreçleri sırasında alınan kan testlerinden elde edilen CRP düzeyleri retrospektif olarak analiz edilmiştir. Hastalar beş farklı CRP düzey grubuna (5-50 mg/L, 51-100 mg/L vb.) ayrılmış ve tıbbi geçmişleri, şikayetleri, hastaneye yatış durumları, konsültasyon talepleri ve mortalite sonuçları değerlendirilmiştir.

Bulgular: CRP düzeyleri 5-100 mg/L arasında olan hastalar daha sık enfektif olmayan nedenlerle tanı alırken, CRP düzeyleri 101 mg/L ve üzerinde olan hastaların çoğunlukla enfektif nedenlerle tanı aldığı gözlemlenmiştir. Yükselmiş CRP düzeyleri ile artmış hastaneye yatış ve mortalite oranları arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur (p < 0,001).

Sonuç: Travmatik olmayan sebeplerle acil servise başvuran geriatrik hastalarda CRP düzeyleri ile konsültasyon ve hastaneye yatış oranları arasında anlamlı bir ilişki gözlemlenmiştir. Ayrıca, yüksek CRP düzeylerinin hastaneye yatırılan hastalar arasında artan mortalite oranları ile güçlü bir şekilde ilişkili olduğu tespit edilmiştir. Bulgular, CRP düzeylerinin 101 mg/L'yi aşması durumunda enfektif tanılar ve olumsuz sonuçlarla ilişkili olduğunu göstermekte ve bu hastaların yakından izlenmesi gerektiğini vurgulamaktadır. CRP düzeyleri, geriatrik hastaların acil servislerdeki karar verme süreçlerinde önemli bir faktör olarak değerlendirilmelidir.

Etik Beyan

Ethical approval was obtained from theKaradeniz Technical University Faculty of Medicine NonInterventional Clinical Research Ethics Committee before the study (Decision No. 2023/200).

Destekleyen Kurum

Destekleyen kurum yoktur.

Kaynakça

  • Black S, Kushner I, Samols D. C-reactive protein. Journal of Biological Chemistry 2004; 279.47: 48487-48490.
  • Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Frontiers in Immunology 2018; 9: 754.
  • Du Clos TW, Mold C. C-reactive protein: an activator of innate immunity and a modulator of adaptive immunity. Immunologic Research 2004; 30: 261-277.
  • Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. New England Journal of Medicine 1999; 340.6: 448-454.
  • Kim BG, Lee YK, Park HP, et al. C-reactive protein is an independent predictor for 1-year mortality in elderly patients undergoing hip fracture surgery: A retrospective analysis. Medicine 2016; 95: 43.
  • Ticinesi A, Lauretani F, Nouvenne A, et al. C-reactive protein (CRP) measurement in geriatric patients hospitalized for acute infection. European Journal of Internal Medicine 2017; 37: 7-12.
  • Kenny RA, Hodkinson HM, Cox ML, et al. Acute phase protein response to infection in elderly patients. Age and Ageing 1984; 13.2: 89-94.
  • Cox ML, Rudd AG, Gallimore R, et al. Real-time measurement of serum C-reactive protein in the management of infection in the elderly. Age and Ageing 1986; 15.5: 257-266.
  • Christ M, Popp S, Erbguth E. Algorithms for the assessment of disorders of consciousness in the emergency department. Intensive Care and Emergency Medicine 2010; 2.47: 83-93.
  • Singler K, Bertsch T, Heppner HJ, et al. Diagnostic accuracy of three different methods of temperature measurement in acutely ill geriatric patients. Age and Ageing 2013; 42.6: 740-746.
  • Simonetti AF, Viasus D, Garcia-Vidal C, et al. Management of community-acquired pneumonia in older adults. Therapeutic Advances in Infectious Disease 2014; 2.1: 3-16.
  • Hogarth MB, Gallimore JR, Savage P, et al. Acute phase proteins, C-reactive protein and serum amyloid A protein, as prognostic markers in the elderly inpatient. Age and Ageing 1997; 26.2: 153-158.
  • Sierra R, Rello J, Bailén MA, et al. C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome. Intensive Care Medicine 2004; 30: 2038-2045.
  • Wester AL, Blaasaas KG, Wyller TB. Is the concentration of C-reactive protein in bacteraemia associated with age? Immunity & Ageing 2008; 5.1: 1-8.
  • Ryu JA, Yang JH, Lee D, et al. Clinical usefulness of procalcitonin and C-reactive protein as outcome predictors in critically ill patients with severe sepsis and septic shock. PloS One 2015; 10.9: e0138150.
  • Viasus D, Del Rio-Pertuz G, Simonetti AF, et al. Biomarkers for predicting short-term mortality in community-acquired pneumonia: A systematic review and meta-analysis. Journal of Infection 2016; 72.3: 273-282.

The Relationship Between CRP Levels and Hospitalization, Discharge, Readmission and Mortality Rates of Geriatric Patients Presenting to the Emergency Department

Yıl 2025, Cilt: 8 Sayı: 1, 25 - 30, 29.03.2025
https://doi.org/10.54996/anatolianjem.1497523

Öz

Aim: This study aims to investigate the association between Creactive protein (CRP) levels and outcomes such as hospitalization, discharge, readmission, and mortality in geriatric patients (aged 65 and over) presenting to the emergency department for nontraumatic reasons.

Material and Methods: CRP levels were retrospectively analyzed from blood tests taken during routine diagnostic and therapeutic processes for patients over 65 years of age who presented to the emergency department of a secondary state hospital for non-traumatic reasons between January 1, 2023, and June 30, 2023. Patients were categorized into five CRP level groups (5-50 mg/L, 51-100 mg/L, etc.) and evaluated for their medical history, complaints, hospitalization status, consultation requests, and mortality.

Results: Patients with CRP levels between 5-100 mg/L were more frequently diagnosed with non-infective causes, while CRP levels over 101 mg/L were predominantly associated with infective causes. A statistically significant association was found between elevated CRP levels and increased rates of hospitalization and mortality (p < 0.001).

Conclusion: A significant relationship was observed between CRP levels and the rates of consultation and hospitalization in geriatric patients admitted to the emergency department for nontraumatic reasons. Additionally, elevated CRP levels were strongly associated with increased mortality rates among hospitalized patients. The findings indicate that CRP levels exceeding 101 mg/L were associated with infectious diagnoses and poor outcomes, highlighting the need for close monitoring of these patients. CRP levels should be considered an integral part of the decision-making process in geriatric emergency patients

Etik Beyan

Ethical approval was obtained from the Karadeniz Technical University Faculty of Medicine NonInterventional Clinical Research Ethics Committee before thestudy (Decision No. 2023/200).

Destekleyen Kurum

This research was conducted without specific financial support from any public, commercial, or nonprofit funding agency.

Kaynakça

  • Black S, Kushner I, Samols D. C-reactive protein. Journal of Biological Chemistry 2004; 279.47: 48487-48490.
  • Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Frontiers in Immunology 2018; 9: 754.
  • Du Clos TW, Mold C. C-reactive protein: an activator of innate immunity and a modulator of adaptive immunity. Immunologic Research 2004; 30: 261-277.
  • Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. New England Journal of Medicine 1999; 340.6: 448-454.
  • Kim BG, Lee YK, Park HP, et al. C-reactive protein is an independent predictor for 1-year mortality in elderly patients undergoing hip fracture surgery: A retrospective analysis. Medicine 2016; 95: 43.
  • Ticinesi A, Lauretani F, Nouvenne A, et al. C-reactive protein (CRP) measurement in geriatric patients hospitalized for acute infection. European Journal of Internal Medicine 2017; 37: 7-12.
  • Kenny RA, Hodkinson HM, Cox ML, et al. Acute phase protein response to infection in elderly patients. Age and Ageing 1984; 13.2: 89-94.
  • Cox ML, Rudd AG, Gallimore R, et al. Real-time measurement of serum C-reactive protein in the management of infection in the elderly. Age and Ageing 1986; 15.5: 257-266.
  • Christ M, Popp S, Erbguth E. Algorithms for the assessment of disorders of consciousness in the emergency department. Intensive Care and Emergency Medicine 2010; 2.47: 83-93.
  • Singler K, Bertsch T, Heppner HJ, et al. Diagnostic accuracy of three different methods of temperature measurement in acutely ill geriatric patients. Age and Ageing 2013; 42.6: 740-746.
  • Simonetti AF, Viasus D, Garcia-Vidal C, et al. Management of community-acquired pneumonia in older adults. Therapeutic Advances in Infectious Disease 2014; 2.1: 3-16.
  • Hogarth MB, Gallimore JR, Savage P, et al. Acute phase proteins, C-reactive protein and serum amyloid A protein, as prognostic markers in the elderly inpatient. Age and Ageing 1997; 26.2: 153-158.
  • Sierra R, Rello J, Bailén MA, et al. C-reactive protein used as an early indicator of infection in patients with systemic inflammatory response syndrome. Intensive Care Medicine 2004; 30: 2038-2045.
  • Wester AL, Blaasaas KG, Wyller TB. Is the concentration of C-reactive protein in bacteraemia associated with age? Immunity & Ageing 2008; 5.1: 1-8.
  • Ryu JA, Yang JH, Lee D, et al. Clinical usefulness of procalcitonin and C-reactive protein as outcome predictors in critically ill patients with severe sepsis and septic shock. PloS One 2015; 10.9: e0138150.
  • Viasus D, Del Rio-Pertuz G, Simonetti AF, et al. Biomarkers for predicting short-term mortality in community-acquired pneumonia: A systematic review and meta-analysis. Journal of Infection 2016; 72.3: 273-282.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Orijinal Çalışma
Yazarlar

Yusuf Kantar 0000-0001-8358-5312

Necmi Baykan 0000-0002-6845-9550

Funda İpekten 0000-0002-6916-9563

Melih İmamoğlu 0000-0003-4197-8999

Erken Görünüm Tarihi 29 Mart 2025
Yayımlanma Tarihi 29 Mart 2025
Gönderilme Tarihi 7 Haziran 2024
Kabul Tarihi 10 Aralık 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 1

Kaynak Göster

AMA Kantar Y, Baykan N, İpekten F, İmamoğlu M. The Relationship Between CRP Levels and Hospitalization, Discharge, Readmission and Mortality Rates of Geriatric Patients Presenting to the Emergency Department. Anatolian J Emerg Med. Mart 2025;8(1):25-30. doi:10.54996/anatolianjem.1497523