Administering Geriatric Pneumonia Cases without Waiting for CRP Results, is It Practicable?

Abstract

Background: C-reactive protein (CRP) is a notable marker of many diseases. Accordingly, in most cases, the clinical management of infectious diseases is revised based on CRP alterations. This study thus attempted to predict CRP alterations via immature granulocyte count (IGC) and nucleated red blood cell count (NRBC) in a geriatric population with pneumonia. Methods: We carried out our study in the intensive care unit of a private hospital by retrospectively reviewing the laboratory findings of geriatric patients with pneumonia and an age-matched control group in the same ICU. Results: In total, we reviewed 495 hospitalization days (the summed amount of days for all 43 patients) and 221 hospitalization days (the summed amount of days for all 20 controls) records. In the group comparisons, we found a statistical significance in the patient group for both IGC (p = 0.001) and NRBC (p = 0.002). Comparing IGC to CRP measures from the following day and the day after that, there was a statistical significance in IGC (p = 0.001) but not in NRBC (p = 0.156). Further, IGCs below 0.3 x 103 and above 0.5 x 103 were better able to predict CRP alterations. Conclusion: In geriatric patients with pneumonia, IGC is more effective than NRBC in predicting CRP variations before their actual occurrence, with the mean estimation time at least 2 days prior.

Keywords

• crp variability
• geriatric pneumonia
• immature granulocyte count
• intensive care unit
• nucleated red blood cell count.