C-reactive protein and emergency department seven days revisit

Ziv‐Baran, Tomer; Wasserman, Asaf; Shteinvil, Ronen; Zeltser, David; Shapira, Itzhak; Shenhar‐Tsarfaty, Shani; Meilik, Ahuva; Goldiner, Ilana; Rogowski, Ori; Berliner, Shlomo; Halpern, Pinchas

doi:10.1016/j.cca.2018.03.022

Cited by 12 publications

(8 citation statements)

References 27 publications

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“…Return visits to the ED are stressful for the physician and constitute a worldwide phenomenon that may be partially preventable. Studies have described short-term revisit after hospital discharge exploring predicting factors, 2,3,5,10 but only a few studies have investigated which factors could be useful in predicting outcomes of a second visit 11,12 . In this cohort of children attending a PED with high levels of CRP (≥150 mg/L) at the initial visit, the level of CRP was not useful in predicting clinical outcomes of children who returned for a second visit within 7 days.…”

Section: Discussionmentioning

confidence: 85%

“…2,4 These studies are mainly from the adult population and frequently use demographic data, mode of arrival, severity indices, comorbidities, and initial diagnosis as predictors, without evaluating laboratory data. Recently, Ziv-Baran et al 5 found that laboratory predictors, such as C-reactive protein (CRP) levels at the initial visit, were an independent predictor for 7-day ED revisit, but did not comment whether elevated CRP correlated with a worse prognosis.…”

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confidence: 99%

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C-Reactive Protein and the Outcome of a Pediatric Emergency Department 7 Days Revisit

et al. 2022

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BackgroundPediatric emergency department (PED) return visits represent an important quality of care metric and constitute a patient-centered outcome. C-reactive protein (CRP) is an inflammatory biomarker that is commonly used as screening tool in the PED. In this study, we assessed the clinical outcomes of children whose levels of CRP are 150 mg/L or higher at the initial PED visit and if such levels could be useful in predicting outcomes at a second PED visit.MethodsA historical cohort study of all patients who visited the PED between July 2007 and June 2017 and had a CRP value of 150 mg/L or greater in the setting of a febrile illness. Data of patients with a return visit to the PED within 7 days were assessed for an association between laboratory values, diagnosis and clinical outcome.ResultsOne hundred thirty-six index visits were included in this study. One hundred fifteen (84.6%) of the revisits were discharged after their second visit, and 21 (15.4%) were admitted to the inpatient unit. Admitted patients did not differ from patients who were discharged home in diagnosis and CRP levels, but a difference in white blood cell and absolute neutrophil counts was observed.ConclusionsThe intensity of the inflammatory response, as expressed by the high concentrations of CRP in children, does not seem to predict the outcome at a repeat PED visit within 7 days.

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Section: Discussionmentioning

confidence: 85%

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confidence: 99%

C-Reactive Protein and the Outcome of a Pediatric Emergency Department 7 Days Revisit

et al. 2022

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“…[48] Many studies have investigated these biomarkers and they have proven to be successful in predicting ED outcomes. [49][50][51][52][53] In addition, a few studies have compared the prognostic ability of suPAR levels with other available biomarkers. A blinded prospective cohort conducted to compare the prognostic ability of suPAR and serum lactate biomarkers showed that high suPAR above 9ng/mL had a significant predictive ability of 30-day mortality (P < .001) whereas lactate was not a significant predictor of 30-day mortality (P = .269).…”

Section: Discussionmentioning

confidence: 99%

Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis

Rehan,

Hussain,

Ali

et al. 2023

Medicine

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Background: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker that is used to predict mortality, readmission, early discharge, and LOS, thus, serves as a useful tool for ED physicians. Our study aims to analyze the efficacy of suPAR in predicting these prognostic markers in ED. Methods: We performed a comprehensive search on 6 databases from the inception to 30th November 2022, to select the following eligibility criteria; a) observation or triage trial studies investigating the role of suPAR levels in predicting: 30 day and 90-day mortality, 30-day readmission, early discharge (within 24hr), and LOS in patients coming to AMU. Results: A total of 13 studies were included, with a population size of 35,178, of which 52.9% were female with a mean age of 62.93 years. Increased risk of 30-day mortality (RR = 10.52; 95% CI = 4.82–22.95; I2 = 38%; P < .00001), and risk of 90-day mortality (RR = 5.76; 95% CI = 3.35–9.91; I2 = 36%; P < .00001) was observed in high suPAR patients. However, a slightly increased risk was observed for 30-day readmission (RR = 1.50; 95% CI = 1.16–1.94; I2 = 54%; P = .002). More people were discharged within 24hr in the low suPAR level group compared to high suPAR group (RR = 0.46; 95% CI = 0.40–0.53; I2 = 41%; P < .00001). LOS was thrice as long in high suPAR level patients than in patients with low suPAR (WMD = 3.20; 95% CI = 1.84–4.56; I2 = 99%; P < .00001). Conclusion: suPAR is proven to be a significant marker in predicting 30-day and 90-day mortality in ED patients.

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“…Contrarily, the PROCEED-CRP study did not demonstrate any correlation between CRP levels and cardiac outcomes among patients admitted for cardiac investigation (18). Elevated CRP levels were recently found to be associated with one-week unplanned return to the ED (19), but the relation between CRP levels and ED revisits among patients presenting with acute chest pain has not been investigated in a large cohort.…”

Section: Introductionmentioning

confidence: 99%

Outcomes after ED visit for acute Chest Pain, with respect to negative but measurable troponin levels and CRP levels

Greenberg,

Cohen,

Shopen

et al. 2024

Preprint

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While chest pain is one of the most common chief complaints in the ED, the majority are discharged for ambulatory care. We explored outcomes of patients who presented to the ED with chest pain as chief compliant, and assessed whether an association exists with negative (but measurable) troponin levels or elevated CRP levels. The primary outcome was a percutaneous intervention (PCI) within 90 days from ED visit, and the secondary outcomes were 7-day revisit, 14-day ward admission, and 30-day mortality. Of 32,170 patients who presented with chest pain to the ED during the 5-year study period, 23,442 (73%) were discharged from the ED and 8,720 were admitted. Among the discharged 14,477 (61.8%) had very-low troponin, of whom only 70 (0.5%) had PCI withing 90 days, compared with 1.9% in patients with negative but measurable troponin levels (n = 169, p < 0.0001). All the secondary outcomes were higher among patients with negative but measurable troponin compared to very-low troponin: 7-days ED revisit rates were 5.3% compared with 3.3% respectively (p < 0.0001), 14-days admission rates were 3.2% and 0.9% respectively (p < 0.0001) and mortality rates were 0.3% compared to 0.01% (p < 0.0001). Troponin levels ≥ 3.5 ng/L were associated with 90-day PCI (aOR 2.0, [95% CI: 1.5–2.7], p < 0.001). An elevated CRP level was an independent protective factor against 90-day PCI (aOR 0.98, p = 0.03), but was associated with all the other outcomes. While nearly 3/4 of ED chest pain visits can be discharge safely, measurable troponin levels may suggest the need for imminent coronary intervention.

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C-reactive protein and emergency department seven days revisit

Cited by 12 publications

References 27 publications

C-Reactive Protein and the Outcome of a Pediatric Emergency Department 7 Days Revisit

C-Reactive Protein and the Outcome of a Pediatric Emergency Department 7 Days Revisit

Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis

Outcomes after ED visit for acute Chest Pain, with respect to negative but measurable troponin levels and CRP levels

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