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Age and Ageing Advance Access originally published online on September 3, 2009
Age and Ageing 2009 38(6):693-697; doi:10.1093/ageing/afp164
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© The Author 2009. Published by Oxford University Press [on behalf of the British Geriatrics Society]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

C-reactive protein, severity of pneumonia and mortality in elderly, hospitalised patients with community-acquired pneumonia

Ulrich Thiem1,2, David Niklaus1, Bettina Sehlhoff1, Christoph Stückle3, Hans Jürgen Heppner4, Heinz Gerd Endres2 and Ludger Pientka1

1 Department of Geriatrics, Marienhospital Herne, University of Bochum, Widumer Str. 8, D-44627 Herne, Germany
2 Department of Medical Informatics, Statistics and Epidemiology, University of Bochum, Overbergstr. 17, D-44801 Bochum, Germany
3 Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, Marienhospital Herne, University of Bochum, Widumer Str. 8, D-44627 Herne, Germany
4 2nd Department of Internal Medicine/Geriatrics, Medical Center Nuremberg, University Erlangen/Nuremberg, Prof.-Ernst-Nathan-Str. 1, D-90419 Nuremberg, Germany

Address correspondence to: U. Thiem. Tel: (+49)-2323-499-5912; Fax: (+49)-2323 499 2621. Email: ulrich.thiem{at}rub.de

Background: increasingly, markers of systemic inflammation like C-reactive protein (CRP) levels and white blood count (WBC) are being used for assessing the prognosis of patients with community-acquired pneumonia (CAP). However, their predictive value has not been validated in populations of elderly patients.

Objective: to evaluate the prognostic value of CRP and WBC in comparison with the CURB score and the pneumonia severity index (PSI) in elderly, hospitalised patients with CAP.

Methods: the charts of all patients, aged 65 years and older, who were consecutively admitted to the Department of Geriatrics, Marienhospital Herne, Germany, for treatment of CAP between January 2001 and September 2005, were reviewed. CRP, WBC, CURB and PSI were analysed in relation to 30-day mortality.

Results: in a total of 391 patients, median age 80 years, no association was found between CRP or WBC and mortality. In contrast, the CURB score and PSI were significantly associated with mortality and treatment in the intensive care unit (ICU).

Conclusion: in elderly, hospitalised patients with CAP, admission CRP and WBC are not predictors of the prognosis.

Keywords: community-acquired pneumonia, CURB score, C-reactive protein, mortality, elderly

Received 25 November 2008; accepted in revised form 30 July 2009.


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