C-Reactive Protein for the Enhanced Evaluation of the Systemic Inflammatory Response Syndrome (SIRS)

Gitta Pancer1, 2, Ester Engelman1, 2, Farhana Hoque1, 3, Mohammed Alam1, James Rucinski1, Larry H. Bernstein*, 1
1 New York Methodist Hospital, Brooklyn, New York, USA
2 Touro College, Brooklyn, New York, USA
3 Midwood High School, Brooklyn, New York, USA

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© 2011 Pancer et al;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the New York Methodist Hospital, Brooklyn, New York, 232 Fitch's Pass, Trumbull, Connecticut 06611, USA; Tel: 1-203-261-8671; E-mail:


Introduction: An elevation in the CRP may provide an early indication of developing SIRS with progression to sepsis that is more sensitive than the standard clinical criteria of fever (or hypothermia), tachypnea, tachycardia, and leukocytosis with neutrophilia (or neutropenia). The problem of false positive rate for SIRS resides mainly in the common occurance of tachypnea and tachycardia in presenting patients, and in the confounding presence of neutrophilia without reference to good measures of a left shift. The objective of this study was to investigate how using CRP as a marker to confirm the presence of early sepsis might reduce the false positive rate inherent in the defining SIRS criteria.

Materials and Methods: One hundred sixty eight patients with leukocytosis greater than 12,000 associated with a high absolute neutrophil count were studied. Those that met the inclusion criteria were analyzed for CRP response.

Results: A linear correlation between CRP elevation and the defining criteria for SIRS was found except there was no correlation with absolute neutrophil count.

Conclusion: CRP is a sensitive indicator of SIRS with advantages over neutrophilia for detecting early sepsis.

Keywords: Systemic inflammatory response, C-reactive protein, early sepsis, SIRS criteria.