Blood Levels of Protein C among Intensive Care Unit Patients in Gaza, Palestine

Abstract

Background: Intensive care unit (ICU) is one of the largest, most expensive, and complex components of health care. However, assessment of protein C (PC) and C- reactive protein (CRP) concentrations in ICU patients may help in identifying high risk groups and potential therapeutic targets. Objective: To estimate the PC levels and CRP among ICU patients and their relations to ICU outcome. Methods: This observational cross sectional study, in Al-Shifa hospital ICU, included 85 patients, and 85 healthy controls. Plasma PC concentrations, and CRP levels were measured. Kidney and liver dysfunctions were assessed biochemically, in addition, coagulation tests were performed. Results: PC levels were below the lower limit of normal in 65.9% of patients (n=56) at admission, irrespective of the presence primary diagnosis and sex. PC levels were lower in non survivors (n=17 ; 20%) than in survivors. There was significant correlation between PC levels and ICU outcome (P=0.001). Patients with high CRP levels upon ICU admission had higher mortality rates than patients with normal levels. There was no significant correlation between CRP levels and ICU outcome (P=0.856). Conclusion: PC concentrations are generally low in ICU patients. PC levels were also associated with organ dysfunction/failure and were independently associated with a higher risk of ICU mortality. CRP levels are considered as a good early marker of morbidity and mortality in these patients. In addition, CRP concentrations may be a valuable addition to predict the risk of death.