• Wilhelm Grander, Bernhard Koller, Christine Ludwig, Martin W Dünser, and Ilse Gradwohl-Matis.
• Department of Intensive Care Medicine, Academic Teaching Hospital Hall in Tirol, Hall in Tirol, Tirol, Austria.
• Shock. 2018 Nov 1; 50 (5): 525-529.

PurposeChronic inflammation, even at subclinical levels, is associated with adverse long-term outcome.Patients And MethodsIn this prospective, observational study, 66 critically ill patients surviving to hospital discharge were included. C-reactive protein (CRP) levels were determined at hospital discharge, 1, 2, and 6 weeks after hospital discharge. All the patients were repeatedly screened for adverse events resulting in rehospitalization or death for 1.5 years.ResultsAfter hospital discharge, over two-thirds of the patients exhibited elevated CRP levels (>2.0 mg/L). During the first week, CRP decreased compared with hospital discharge (P < 0.001) but did not change after week 1 (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.ConclusionsPlasma CRP levels in critically ill patients decreased during the first week after hospital discharge but remained unchanged during the subsequent 5 weeks. Over two-thirds of the patients exhibited elevated CRP levels compatible with chronic sub-clinical inflammation. Persistently elevated CRP levels after hospital discharge are associated with higher risk of rehospitalization.

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