C-reactive protein (CRP) measurement in geriatric patients hospitalized for acute infection

  • Andrea Ticinesi
    Corresponding author at: Department of Clinical and Experimental Medicine, University of Parma and Internal Medicine and Critical Subacute Care Unit, Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy.
    Department of Clinical and Experimental Medicine, University of Parma, Italy

    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Italy
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  • Fulvio Lauretani
    Department of Clinical and Experimental Medicine, University of Parma, Italy

    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Italy
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  • Antonio Nouvenne
    Department of Clinical and Experimental Medicine, University of Parma, Italy

    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Italy
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  • Emanuela Porro
    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Italy
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  • Guido Fanelli
    Department of Surgical Sciences, University of Parma, Italy

    Anesthesia, Intensive Care and Pain Therapy Unit, Azienda Ospedaliero-Universitaria di Parma, Italy
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  • Marcello Maggio
    Department of Clinical and Experimental Medicine, University of Parma, Italy

    Clinical Geriatrics Unit, Medicine Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Italy
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  • Tiziana Meschi
    Department of Clinical and Experimental Medicine, University of Parma, Italy

    Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Italy
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Published:September 01, 2016DOI:


      • 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.


      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.


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