Abstract

INTRODUCTION

Several biomarkers are used to detect infections, evaluate prognosis and assess treatment response. In this study we evaluated biomarkers commonly used in the diagnosis and prognosis of bacterial infections among geriatric patients in palliative care.

METHODS

This descriptive, cross-sectional study included inpatients treated in the palliative care unit of our hospital for a period of more than two days between November 2015 and February 2016.

RESULTS

A total of 63 palliative care patients with a mean age of 80 years were included; 55.6% of the patients were male. Eighty-one percent of the patients developed an infection and were treated with an antibiotic. Biomarkers measured on the first day of hospitalization were evaluated in two groups, patients with and without infections. ROC analysis revealed the diagnostic powers of C-reactive protein (CRP) and albumin were 76.2% and 73.9%, respectively (p<0.05). The diagnostic power of the CRP/albumin ratio was 81.3% (p<0.001). In ROC analysis to predict prognosis in patients with infection, CRP had a predictive power of 83.9% and albumin of 78.0% (p<0.05). With a cut-off value of 8.23 mg/dl, CRP showed 75.8% specificity and 88.9% sensitivity in detecting infection; for albumin, these values were 44.4% and 93.9% with a cut-off value of 2.27 mg/dl. The CRP/albumin ratio had a prognostic predictive power of 84.3% (p<0.001) and showed 72.4% specificity and 94.4% sensitivity in detecting infection at a cut-off value of 2.89.

DISCUSSION AND CONCLUSION

CRP and albumin are indicators of inflammation and nutritional status, and we believe their evaluation within 24 hours of hospitalization is beneficial in determining prognosis.