Highlights
- •Age-related immunologic rearrangements can affect markers of acute inflammation.
- •Serum CRP elevation can help diagnosing acute infection in older hospitalized patients.
- •CRP measurement may provide prognostic information in older inpatients.
- •The significance of CRP kinetics in older patients with infection is poorly known.
Abstract
The physiology of inflammatory response is modified by the aging process and is substantially
affected by multimorbidity and disability. Infection is the most frequent cause of
acute inflammation in both adult and older subjects. C-reactive protein (CRP) is the
most used biomarker of inflammation, and a substantial amount of literature has demonstrated
its importance and clinical usefulness in adult subjects. However, the clinical significance
of serum CRP determination has not been completely clarified in older subjects with
acute infection, especially in the light of the age-related rearrangements in immunity
and cytokine production. Thus, in the present review, we focus on the existing knowledge
about serum CRP level interpretation in geriatric patients hospitalized with acute
infection. Our aims were to determine the significance of CRP measurement at hospital
admission for establishing a diagnosis of infection and/or a prognosis and to evaluate
whether it is indicated to repeat hs-CRP measurements during hospital stay for monitoring
disease course and, possibly, guiding the discharge timing. We concluded that CRP
dosage at hospital admission is helpful to detect acute infection, and particularly
sepsis, in geriatric patients, and that CRP elevation may provide valuable short-term
prognostic information. At the current state of art, serial CRP measurements are instead
not indicated to monitor disease course and plan hospital discharge in this setting.
Keywords
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Article info
Publication history
Published online: September 01, 2016
Accepted:
August 21,
2016
Received in revised form:
July 31,
2016
Received:
May 6,
2016
Footnotes
☆Funding source: none.
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
