C-reactive protein in the early diagnosis of pneumonia complicating severe blunt chest trauma

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Published Nov 18, 2023
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Vol. 101 No. 10 (2023): Tunis med oct 2023

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Becem Trabelsi
Department of Anesthesiology and Intensive Care, Taher Maamouri Teaching Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Sahar Ghorbel
Department of Anesthesiology and Intensive Care, Taher Maamouri Teaching Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Rania Ben Rabeh
Pediatric Department C, Bechir Hamza Children's Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Mahdi Bouassida
Department of Surgery, Taher Maamouri Teaching Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Mechaal Ben Ali
Department of Anesthesiology and Intensive Care, Taher Maamouri Teaching Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia

Abstract

Background: The early diagnosis of pneumonia following severe blunt chest trauma (SBCT) allows the early prescription of antibiotics and initiation of adequate supportive care.


Aim: To assess the usefulness of C-reactive protein (CRP) in the early diagnosis of pneumonia complicating SBCT.


Methods: We conducted a prospective study of patients admitted to trauma intensive care unit for SBCT between January 2020 and February 2023. Patients were divided into two groups according to whether or not they developed pneumonia. The CRP levels were monitored daily.


Results: One hundred sixty-seven patients were included. Pneumonia occurred in 40.1% of patients within a median of 5 days. We found statistically significant difference in mean CRP levels between groups from day 3 to day 9 following trauma. The increase in CRP level on the 4th day from a value greater than or equal to 192 mg/L was a marker of early diagnosis of pneumonia (sensitivity 80.6%; specificity 80.8%).


Conclusion: Daily CRP measurement from the 3rd day following SBCT may be useful for early diagnosis of pneumonia complicating SBCT.

Keywords:

C-reactive protein, Complications, Multiple trauma, Thoracic injuries

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