{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T01:02:33Z","timestamp":1775696553729,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2012,3,26]],"date-time":"2012-03-26T00:00:00Z","timestamp":1332720000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2012,3,26]],"date-time":"2012-03-26T00:00:00Z","timestamp":1332720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Community-acquired pneumonia (CAP) requiring intensive care unit (ICU) admission remains a severe medical condition, presenting ICU mortality rates reaching 30%. The aim of this study was to assess the value of different patterns of C-reactive protein (CRP)-ratio response to antibiotic therapy in patients with severe CAP requiring ICU admission as an early maker of outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 191 patients with severe CAP were prospectively included and CRP was sampled every other day from D1 to D7 of antibiotic prescription. CRP-ratio was calculated in relation to D1 CRP concentration. Patients were classified according to an individual pattern of CRP-ratio response with the following criteria: fast response - when D5 CRP was less than or equal to 0.4 of D1 CRP concentration; slow response - when D5 CRP was &gt; 0.4 and D7 less than or equal to 0.8 of D1 CRP concentration; nonresponse - when D7 CRP was &gt; 0.8 of D1 CRP concentration. Comparison between ICU survivors and non-survivors was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CRP-ratio from D1 to D7 decreased faster in survivors than in non-survivors (p = 0.01). The ability of CRP-ratio by D5 to predict ICU outcome assessed by the area under the ROC curve was 0.73 (95% Confidence Interval, 0.64 - 0.82). By D5, a CRP concentration above 0.5 of the initial level was a marker of poor outcome (sensitivity 0.81, specificity 0.58, positive likelihood ratio 1.93, negative likelihood ratio 0.33). The time-dependent analysis of CRP-ratio of the three patterns (fast response\n                      <jats:italic>n<\/jats:italic>\n                      = 66; slow response\n                      <jats:italic>n<\/jats:italic>\n                      = 81; nonresponse\n                      <jats:italic>n<\/jats:italic>\n                      = 44) was significantly different between groups (p &lt; 0.001). The ICU mortality rate was considerably different according to the patterns of CRP-ratio response: fast response 4.8%, slow response 17.3% and nonresponse 36.4% (p &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In severe CAP, sequential evaluation of CRP-ratio was useful in the early identification of patients with poor outcome. The evaluation of CRP-ratio pattern of response to antibiotics during the first week of therapy was useful in the recognition of the individual clinical evolution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/cc11291","type":"journal-article","created":{"date-parts":[[2012,3,26]],"date-time":"2012-03-26T14:14:32Z","timestamp":1332771272000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Patterns of c-reactive protein RATIO response in severe community-acquired pneumonia: a cohort study"],"prefix":"10.1186","volume":"16","author":[{"given":"Lu\u00eds M","family":"Coelho","sequence":"first","affiliation":[]},{"given":"Jorge IF","family":"Salluh","sequence":"additional","affiliation":[]},{"given":"M\u00e1rcio","family":"Soares","sequence":"additional","affiliation":[]},{"given":"Fernando A","family":"Bozza","sequence":"additional","affiliation":[]},{"given":"JuanCarlos R","family":"Verdeal","sequence":"additional","affiliation":[]},{"given":"Hugo C","family":"Castro-Faria-Neto","sequence":"additional","affiliation":[]},{"given":"Jos\u00e9 Roberto","family":"Lapa e Silva","sequence":"additional","affiliation":[]},{"given":"Patr\u00edcia T","family":"Bozza","sequence":"additional","affiliation":[]},{"given":"Pedro","family":"P\u00f3voa","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2012,3,26]]},"reference":[{"key":"535_CR1","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1034\/j.1399-3003.2000.15d21.x","volume":"15","author":"J Almirall","year":"2000","unstructured":"Almirall J, Bolibar I, Vidal J, Sauca G, Coll P, Niklasson B, Bartolome M, Balanzo X: Epidemiology of community-acquired pneumonia in adults: a population-based study.\n                           Eur Respir J 2000, 15: 757-763. 10.1034\/j.1399-3003.2000.15d21.x","journal-title":"Eur Respir J"},{"key":"535_CR2","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1378\/chest.07-1456","volume":"133","author":"MI Restrepo","year":"2008","unstructured":"Restrepo MI, Mortensen EM, Velez JA, Frei C, Anzueto A: A comparative study of community-acquired pneumonia patients admitted to the ward and the ICU.\n                           Chest 2008, 133: 610-617. 10.1378\/chest.07-1456","journal-title":"Chest"},{"key":"535_CR3","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1001\/jama.1996.03530260048030","volume":"275","author":"MJ Fine","year":"1996","unstructured":"Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld LA, Kapoor WN: Prognosis and outcomes of patients with community-acquired pneumonia. 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