Correlation of C-reactive protein with other acute inflammatory markers in patients with trauma

Abstract

Background: Trauma patients present daily in most public hospitals in Nigeria and are prone to infections if not properly managed. Adequate investigation of these patients reduces morbidity and mortality.
Aim: This study determined the levels of high sensitivity C- reactive protein (h-sCRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and random plasma glucose (RPG) in the blood of trauma patients on the first, third and eighth day following trauma with simultaneous temperature monitoring.

Method: Subjects were patients who were involved in vehicular crashes, burns, falls or other traumatic cases. A structured questionnaire was administered to document their ages, sex, occupation, date and time of admission, duration of hospital stay and complications. Samples were taken for estimation of h-sCRP, ESR, WBC and RPG on days 1, 3, and 8.

Results: A total of 116 patients and 30 controls completed the study. The WBC was highest on the first day and declined subsequently. The mean ESR peaked on the eighth day while the mean RPG had a peak on the third day. The mean h-sCRP was higher on the third day following trauma (372.4 ± 131.2mg/L) than in controls (69.4 ± 68.1mg/L). It was higher in patients who had surgical interventions (449.5 ± 45.6mg/L) than in those who did not (362.2 ± 136.0mg/L) These differences were statistically significant.
Conclusion: Acute phase biomarkers such as h-sCRP increases in the blood of trauma patients as a result of tissue damage but declines after the third day following trauma. However in the presence of infection, the increase is sustained and thus it can be used to predict the presence and onset of infection in these patients.

Keywords: High sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), Random plasma glucose (RPG), Erythrocyte sedimentation rate (ESR), Trauma, Infection.