Elsevier

Respiratory Medicine

Volume 107, Issue 7, July 2013, Pages 1087-1093
Respiratory Medicine

Diagnostic properties of C-reactive protein for detecting pneumonia in children

https://doi.org/10.1016/j.rmed.2013.04.012Get rights and content
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Summary

Background

The diagnostic value of C-reactive protein (CRP) level for pneumonia in children is unknown. As a first step in the assessment of the value of CRP, a diagnostic study was performed in children at an emergency department (ED).

Methods

In this cross-sectional study, data were retrospectively collected from children presenting with suspected pneumonia at the ED of Antonius Hospital Nieuwegein in The Netherlands between January 2007 and January 2012. Diagnostic outcome was pneumonia yes/no according to independent radiologist. (Un)adjusted association between CRP level and pneumonia and diagnostic value of CRP were calculated.

Results

Of 687 presenting children, 286 underwent both CRP measurement and chest radiography. 148 had pneumonia (52%). The proportion of pneumonia increased with CRP level. Negative predictive values declined, but positive predictive values increased with higher CRP thresholds. Univariable odds ratio for the association between CRP level and pneumonia was 1.2 (95% CI 1.11–1.21) per 10 mg/L increase. After adjustment for baseline characteristics CRP level remained associated with pneumonia.

Conclusions

CRP level has independent diagnostic value for pneumonia in children presenting at the ED with suspected pneumonia, but low levels do not exclude pneumonia in this setting. These results prompt evaluation of CRP in primary care children with LRTI.

Keywords

Lower respiratory tract infection
Diagnosis
Chest radiography
Childhood pneumonia
Logistic regression
Diagnostic accuracy

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