A Hospital Based Retrospective Assessment of C-Reactive Protein (CRP) Profile of Children with Acute Bronchiolitis

Description

Abstract (English)

Abstract
Aim: This study was aimed at assessing the frequency of elevated CRP in children with acute
bronchiolitis and at comparing the clinical characteristics, laboratory and radiological
findings, antibiotics use, and outcome according to CRP levels.
Methods: This was a retrospective, cross-sectional, and analytical study where the electronic
medical records of all patients with a clinical impression of acute bronchiolitis and were
admitted to the pediatric department at JLNMC, Bhagalpur, Bihar, India for the period of one
year were retrieved. During the study period, a total of 200 patients were admitted with a
clinical presentation of acute bronchiolitis. 50 (25%) patients were excluded due to of
unavailability of data of CRP levels. The remaining 150 (75%) patients were included in the
study.
Results: 85 (56.66%) patients were males. The most common clinical presentation was
cough (115 (76.66%) patients) followed by fever (105 (70%) patients). Antibiotics were used
in 80% patients. 6% patients required intensive care, 2 % had surgical intervention, 2%
required endotracheal intubation, and 1 (1%) died. Patients with high CRP were older at
presentation (P < 0:0001) and had more fever (P < 0:0001) and cough (P = 0:002), but lower
hemoglobin level (P < 0:0001) compared to those with normal CRP. Fever (P = 0:016) and
hemoglobin level (P = 0:002) were independent factors.
Conclusion: Most children with acute bronchiolitis had high rate of elevated CRP values that
did not correlate with the rate of bacterial coinfection. High CRP levels were found in older
children, those presented with more fever and cough, and had a lower hemoglobin level
despite that those factors were previously reported to be associated with disease severity and
bacterial coinfection. This study also showed a high overall rate of antibiotic prescriptions in
mostly viral disease