Diagnostic Accuracy of C-Reactive Protein as a Predictor of Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease
DOI:
https://doi.org/10.51985/Keywords:
Acute disease, Biomarker, C-reative protein (CRP), Chronic obstructive pulmonary disease (COPD)Abstract
Objective: This study aimed to assess the diagnostic accuracy of CRP as a predictor of readmission for acute exacerbations of chronic obstructive pulmonary disease (AECOPD), with 30-day readmission as the gold standard. Study design and setting: A prospective observational study was carried out at the Institute of TB and Chest Medicine, Mayo Hospital, Lahore, over six months from April 2025 to September 2025.
Methods: A total of 201 patients aged 40–70 years with a confirmed diagnosis of COPD, as per GOLD 2025 guidelines, and presenting with AECOPD were enrolled using a non-probability consecutive sampling technique. Serum CRP levels were measured on admission using the Spectra 1000 analyzer. Participants were followed for 30 days post-discharge to record readmissions. Data were analyzed using SPSS version 27.0. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CRP =15.8 mg/dl for predicting 30-day readmission were calculated.
Results: The mean age of participants was 53.80 ± 8.99 years, with 56.7% males. The mean CRP level was 16.37 ± 19.46 mg/dl. Higher CRP levels were significantly associated with advanced GOLD stages (p < 0.001). Overall, 30.8% experienced 30-day readmission. CRP = 15.8 mg/dl predicted readmission with sensitivity 70.9%, specificity 75.5%, and diagnostic accuracy 74.1% (p < 0.001).
Conclusion: Elevated CRP is significantly associated with COPD severity and early readmission, suggesting its role as a useful prognostic biomarker for AECOPD management. CRP could serve as a simple, inexpensive biomarker for identifying high-risk patients and guiding post-discharge management to reduce readmissions
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