The Relationship of Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) with an Uncertain Prognosis for the Patients Admitted to the Intensive Care Unit in Alzahra Hospital, Isfahan, Iran, during 2014-2015

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center AND Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

2 Anesthesiology and Critical Care Research Center, Isfahan University of Medical sciences, Isfahan, Iran

3 Resident, Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

Abstract

Background: This study aimed to the relationship of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) with an uncertain prognosis for the patients admitted to the intensive care unit (ICU) in Alzahra Hospital, Isfahan, Iran, during 2014-2015.Methods: In a cross-sectional study, 100 patients admitted in intensive care units of Alzahra hospital were selected and within five days, C-reactive protein level and erythrocyte sedimentation rate were measured. In addition, all the patients were studied for incidence of delirium.Findings: During 5 days of hospitalization, 46 patients were suffering from delirium. The mean erythrocyte sedimentation rate in the two groups with and without delirium was 9.11 ± 2.00 and 8.73 ± 2.02 millimeter per hour, respectively, and there was no significant difference between the two groups (P = 0.340). Mean serum C-reactive protein level in two groups with and without delirium was 12.20 ± 6.06 and 9.55 ± 4.27, respectively (P = 0.012).Conclusion: Changes in the level of inflammatory markers such as C-reactive protein in patients during hospitalization in intensive care units, especially in the first days of hospitalization and in the elderly, can be a good indicator for predicting the incidence of delirium. But, considering the differences in various studies, we recommend that more studies with larger sample sizes should be conducted.

Keywords


  1. Girard TD, Pandharipande PP, Ely EW. Delirium in the intensive care unit. Crit Care 2008; 12(Suppl 3): S3.
  2. Ely EW, Stephens RK, Jackson JC, Thomason JW, Truman B, Gordon S, et al. Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: a survey of 912 healthcare professionals. Crit Care Med 2004; 32(1): 106-12.
  3. Mac Sweeney R, Barber V, Page V, Ely EW, Perkins GD, Young JD, et al. A national survey of the management of delirium in UK intensive care units. QJM 2010; 103(4): 243-51.
  4. Fricchione GL, Nejad SH, Esses JA, Cummings TJ Jr, Querques J, Cassem NH, et al. Postoperative delirium. Am J Psychiatry 2008; 165(7): 803-12.
  5. Urden LD, Stacy KM, Lough ME. Thelan's critical care nursing: diagnosis and management. Philadelphia, PA: Mosby; 2010.
  6. Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med 2007; 33(1): 66-73.
  7. Koster S, Hensens AG, Oosterveld FG, Wijma A, van der Palen J. The delirium observation screening scale recognizes delirium early after cardiac surgery. Eur J Cardiovasc Nurs 2009; 8(4): 309-14.
  8. Rudolph JL, Jones RN, Grande LJ, Milberg WP, King EG, Lipsitz LA, et al. Impaired executive function is associated with delirium after coronary artery bypass graft surgery. J Am Geriatr Soc 2006; 54(6): 937-41.
  9. Devlin JW, Fong JJ, Howard EP, Skrobik Y, McCoy N, Yasuda C, et al. Assessment of delirium in the intensive care unit: nursing practices and perceptions. Am J Crit Care 2008; 17(6): 555-65.
  10. Wei LA, Fearing MA, Sternberg EJ, Inouye SK. The confusion assessment method: a systematic review of current usage. J Am Geriatr Soc 2008; 56(5): 823-30.
  11. Young J, Leentjens AF, George J, Olofsson B, Gustafson Y. Systematic approaches to the prevention and management of patients with delirium. J Psychosom Res 2008; 65(3): 267-72.
  12. Van Rompaey B, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for delirium in intensive care patients: a prospective cohort study. Crit Care 2009; 13(3): R77.
  13. Sockalingam S, Parekh N, Bogoch II, Sun J, Mahtani R, Beach C, et al. Delirium in the postoperative cardiac patient: a review. J Card Surg 2005; 20(6): 560-7.
  14. Flagg B, Cox L, McDowell S, Mwose JM, Buelow JM. Nursing identification of delirium. Clin Nurse Spec 2010; 24(5): 260-6.
  15. Cerejeira J, Mukaetova-Ladinska EB. A clinical update on delirium: from early recognition to effective management. Nurs Res Pract 2011; 2011: 875196.
  16. Deiner S, Silverstein JH. Postoperative delirium and cognitive dysfunction. Br J Anaesth 2009; 103(Suppl 1): i41-i46.
  17. Kazmierski J, Kowman M, Banach M, Fendler W, Okonski P, Banys A, et al. Incidence and predictors of delirium after cardiac surgery: Results from The IPDACS Study. J Psychosom Res 2010; 69(2): 179-85.
  18. Inouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 1999; 340(9): 669-76.
  19. Adamis D, Meagher D. Insulin-like growth factor I and the pathogenesis of delirium: a review of current evidence. J Aging Res 2011; 2011: 951403.
  20. Zhang Z, Pan L, Deng H, Ni H, Xu X. Prediction of delirium in critically ill patients with elevated C-reactive protein. J Crit Care 2014; 29(1): 88-92.
  21. Macdonald A, Adamis D, Treloar A, Martin F. C-reactive protein levels predict the incidence of delirium and recovery from it. Age Ageing 2007; 36(2): 222-5.
  22. Liukkonen T, Silvennoinen-Kassinen S, Jokelainen J, Rasanen P, Leinonen M, Meyer-Rochow VB, et al. The association between C-reactive protein levels and depression: Results from the northern Finland 1966 birth cohort study. Biol Psychiatry 2006; 60(8): 825-30.
  23. Graham JE, Robles TF, Kiecolt-Glaser JK, Malarkey WB, Bissell MG, Glaser R. Hostility and pain are related to inflammation in older adults. Brain Behav Immun 2006; 20(4): 389-400.
  24. Foroughan M, Delbari A, Said SE, AkbariKamrani AA, Rashedi V, Zandi T. Risk factors and clinical aspects of delirium in elderly hospitalized patients in Iran. Aging Clin Exp Res 2016; 28(2): 313-9.