TY - JOUR T1 - Can acute phase proteins predict survival in ventilated patients with acute exacerbation of COPD? JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P4818 AU - Gamal Agmy AU - Hoda Maghlouf AU - Safaa Wafy AU - Yasser Ahmed AU - Shahban Radwan Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P4818.abstract N2 - Background: Factors determining in-hospital mortality of patients ventilated with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood.PURPOSE: The aim of this study was to assess the correlation between acute phase proteins [High sensitivity C-reactive protein (CRP) and prealbumin (PA)] and mortality in ventilated patients with COPD.METHODS: We evaluated 336 COPD patients with AECOPD and on invasive mechanical ventilation. Detailed clinical evaluation was done daily. Concentration of CRP and PA was measured on admission, 3rd, 8th and 16th day.RESULTS: During the study; 237 patients were discharged and 99 died. The difference between the two groups in CRP and PA was significant at admission, 3rd, 8th day and 16th day. In non survivors; there was a significant increase in CRP values with a significant decrease in PA with time (P<0.001). In-hospital mortality was significantly associated with lower arterial oxygen tension, higher carbon dioxide arterial tension, lower arterial oxygen saturation, lower body mass index and longer hospital stay.CONCLUSIONS: CRP levels in patients who died was significantly higher on admission, 3rd, 8th and 16th day. A fall in CRP levels on follow up indicated a significantly better prognosis. An increase in the prealbumin level was observed in survivors.CLINICAL IMPLICATIONS: Persistently high CRP and low prealbumen in COPD patients on ventilator is associated with poor prognosis. Aggressive treatment of systemic inflammation and malnutrition may improve prognosis. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, duration of hospitalisation. ER -