C-reactive protein correlates to functional score systems of patients in general surgical intensive care unit

Abstract

The aim of our study was to document the relationship between inflammation indicated by the serum levels of widespread acute-phase proteins and scoring systems used in assessing patients functional condition. We therefore assessed serum levels of c-reactive protein (CRP) and four clinical tests [acutephysiology and chronic health evaluation (APACHE) II score and sequential organ failure assessment (SOFA) score, functional independence measure (FIM) and Barthel index of activities of daily living (BI)]. We tested the hypothesis that results of functional tests correlate with infections and consecutively influence the length of stay (LOS) in non-specialized general intensive care units (ICUs). One hundred and twenty patients from non-specialized general ICU were enrolled in the study group. We scored patients consecutively on admission (APACHE II-initial; SOFA-initial, FIM initial and BI initial) and on the fifth day of stay (APACHE II-5th day; SOFA-5th day, FIM 5th day and BI 5th day). At the same time points, serum levels of CRP were assessed. FIM index did not correlate to the CRP at any time point (FIM- initial=0.027; FIM- 5th day=0.024; respectively) at discharge, total number of hospital days, i.e. LOS was recorded. Serum CRP values and APACHE II, SOFA, and BI scores correlated positively both on admission and on the fifth day of stay in the general surgical ICU (APACHE II- initial r=0.289; SOFA- initial r=0.305; BI - initial r=0.291; APACHE II 5th day r=0.728; SOFA-5th day r=0.725; BI 5th day r=0.792). Therefore, pending further studies, functional scoring in general surgical ICUs might prove useful in assessing LOS.