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Chung, Hwang, Park, Shin, Jung, Lee, Park, Jung, Kim, and Kim: Inflammatory Markers as Prognostic Factors for Patients with ARDS
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(2): 99-104.

Published online: 31 August 2008

DOI: https://doi.org/10.4046/trd.2008.65.2.99

Inflammatory Markers as Prognostic Factors for Patients with ARDS

Chae Uk Chung, M.D., Jae Hee Hwang, M.D., Ji Won Park, M.D., Ji Young Shin, M.D., Sun Yuong Jung, M.D., Jeong Eun Lee, M.D., Hee Sun Park, M.D., Sung Soo Jung, M.D., Ju Ock Kim, M.D., Sun Young Kim, M.D.

Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.

Address for correspondence: Sun Young Kim, M.D. Department of Internal Medicine, Chungnam National University Hospital, 640, Daesa-dong, Jung-gu, Daejeon 301-721, Korea. Phone: 82-42-280-7154, Fax: 82-42-257-5753, sykim@cnu.ac.kr

Received 7 May 2008       Accepted 14 July 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Acute respiratory distress syndrome (ARDS) is ultimately an inflammatory state. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are inflammatory markers. The aim of this study was to evaluate the value of the ESR, CRP and APACHE II score as prognostic factors for patient with ARDS.

Methods

We retrospectively analyzed the medical records of 87 ARDS patients. The predictors (APACHE II score, ESR and CRP) and outcomes (mortality and length of the total hospital stay, the ICU stay and mechanical ventilator care) were obtained from the patients' records. The patients were grouped according to survival as the Survivor and Non survivor groups. We compared the APACHE II score, the ESR and the CRP level between the survivor group and the nonsurvivor group. We evaluated the correlation between the predictors and the outcomes. The initial ESR, CRP level and APACHE II score were checked at the time of ICU admission and the second ESR and CRP level were checked 3.3±1.2 days after ICU admission.

Results

Thirty-eight (43.7%) patients remained alive and 49 (56.3%) patients died. The APACHE II score was significantly lower for the survivor group than that for the non survivor group (14.7±7.6 vs 19.6±9.1, respectively, p=0.006). The initial ESR and CRP level were not different between the survivor and non-survivor groups (ESR 64.0±37.8 mm/hr vs 63.3±36.7 mm/hr, respectively, p=0.93, CRP 15.5±9.6 mg/dl vs 16.3±8.5 mg/dl, respectively, p=0.68). The decrement of the CRP level for the survivor group was greater than that for the non survivor group (-8.23±10.0 mg/dl vs -1.46±10.1 mg/dl, respectively, p=0.003). Correlation analysis revealed the initial ESR was positively correlated with the length of the total hospital stay and the ICU stay (correlation coefficient of the total hospital days: R=0.43, p=0.001, correlation coefficient of the ICU stay: R=0.39, p=0.014).

Conclusion

The initial APACHE II score can predict the mortality of ARDS patients, and the degree of the early CRP change can be a predictor of mortality for ARDS patients. The initial ESR has positive correlation with the ARDS patients' duration of the total hospital stay and the ICU stay.

Keywords: APACHE II, Acute respiratory distress syndrome, C reactive protein, Erythrocyte sedimentation rate, Prognosis

Figures and Tables

Table 1
Baseline characteristics of the survivors and non-survivors
trd-65-99-i001
Table 2
Comparison of change of ESR and CRP
trd-65-99-i002
Table 3
Pearson's correlation analysis of ESR , CRP and APACHE II score with Hospital stay, ICU stay and Mechanical ventilation
trd-65-99-i003

C.E: coefficient.

*p<0.05 C.E.

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