High CRP Levels After Critical Illness are Associated with an Increased Risk of Re-Hospitalization.

PURPOSE: Chronic inflammation, even at subclinical levels, is associated with adverse long-term outcome.

MATERIALS AND METHODS: In this prospective, observational study, sixty-six critically ill patients surviving to hospital discharge were included. CRP levels were determined at hospital discharge, one, two and six weeks after hospital discharge. All patients were repeatedly screened for adverse events resulting into re-hospitalization or death for 1.5 years.

RESULTS: After hospital discharge, over two thirds of patients exhibited elevated CRP levels (> 2.0 mg/L). During the first week, CRP decreased compared to hospital discharge (p < 0.001) but did not change after week one (p = 0.67). Age (p = 0.24), surgical status (p = 0.95), or sepsis (p = 0.77) did not influence the CRP course. The latter differed between patients with (n = 15) and without (n = 51) adverse events (p = 0.003). CRP levels of patients without adverse events persistently decreased after hospital discharge (p = 0.03), whereas those of patients with adverse events did not (p = 0.86) but rebounded early.

CONCLUSIONS: Plasma CRP levels in critically ill patients decreased during the first week after hospital discharge but remained unchanged during the subsequent five weeks. Over two thirds of patients exhibited elevated CRP levels compatible with chronic sub-clinical inflammation. Persistently elevated CRP levels after hospital discharge are associated with higher risk of re-hospitalisation.