Trial reportCritical care (London, England)2011
Procalcitonin and C-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients.
Trial report in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 2 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- A systematic review of the overlap of fluid biomarkers in delirium and advanced cancer-related syndromes.BMC psychiatry · 2020Pooled it
- Impact of Ultrasound-Guided Rectus Abdominis Sheath Block on Analgesia and Agitation During the Awakening Period in Children Undergoing Single-Incision Laparoscopic Inguinal Hernia Repair: A Randomized Clinical Trial.Journal of pain research · 2025Trial
- Trial
- Preoperative C-Reactive Protein as a Risk Factor for Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Surgery for Colon Carcinoma.BioMed research international · 2017Trial
- Delirium in Children Hospitalized with Acute COVID-19 or MIS-C: Secondary Analysis of the 2020-2021 Global Consortium Study of Neurologic Dysfunction in COVID-19.Neurocritical care · 2026Observational
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Blood-based biomarkers and delirium in critically ill adults in the ICU: a systematic review.Intensive care medicine experimental · 2026Review
- Severe hypotension but not systemic inflammation or endothelial activation predicts encephalopathy in circulatory shock.Annals of intensive care · 2026Article
- Mechanical Ventilation Suppresses Glymphatic Function in Parallel with Delirium-Like Symptoms in Mice.bioRxiv : the preprint server for biology · 2025Article
- Direct and indirect associations of stress hyperglycemia with delirium in older adults with community-acquired pneumonia: limited mediation by neutrophil-lymphocyte ratio and procalcitonin.BMC geriatrics · 2025Article
- Influence of different anesthetic depth on postoperative delirium in elderly pre-frail patients undergoing abdominal surgery.Perioperative medicine (London, England) · 2025Article
- Management of severe acute encephalopathy in the ICU: an expert consensus statement from the french society of intensive care medicine.Annals of intensive care · 2025Review
- Inflammatory Subphenotype Is Associated with Acute Brain Dysfunction in Mechanically Ventilated Patients.Annals of the American Thoracic Society · 2024Article
- Machine learning-based model to predict delirium in patients with advanced cancer treated with palliative care: a multicenter, patient-based registry cohort.Scientific reports · 2024Article
- Systemic inflammation and delirium during critical illness.Intensive care medicine · 2024Article
- Machine learning for prediction of delirium in patients with extensive burns after surgery.CNS neuroscience & therapeutics · 2023Article
- Meta-analysis of serological biomarkers at hospital admission for the likelihood of developing delirium during hospitalization.Frontiers in neurology · 2023Article
- Application of Multiple Omics to Understand Postoperative Delirium Pathophysiology in Humans.Gerontology · 2023Review
- Septic encephalopathy in the elderly - biomarkers of potential clinical utility.Frontiers in cellular neuroscience · 2023Review
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
introductionNon-intensive care unit (ICU) cohorts have shown an association between inflammatory disturbances and delirium, though these relationships have not been studied in critically ill patients. This study sought to investigate the relationship between two inflammatory biomarkers, procalcitonin and C-reactive protein (CRP), and duration of acute brain dysfunction in ventilated patients.
methodsPatients enrolled in the Maximizing Efficacy of Targeted Sedation and Reducing Neurological Dysfunction (MENDS) trial were assessed daily for delirium using the Confusion Assessment Method-ICU. Plasma levels of procalcitonin and CRP were obtained within 24 hours of enrollment. Proportional odds logistic regression was used to examine the association between procalcitonin and CRP separately with delirium/coma-free days, adjusting for age, acute physiology score (APS) of the Acute Physiology And Chronic Health Evaluation (APACHE) II, sedation group (dexmedetomidine vs. lorazepam), and sepsis. Secondary analyses examined the association of these markers with other organ dysfunctions and 28-day survival.
resultsEighty-seven patients were included in this analysis. The median age of the patients was 60 years with APACHE II scores of 28; 68% had sepsis within 48 hours of admission. Higher levels of procalcitonin were associated with fewer delirium/coma-free days [odds ratio (OR), 0.5; 95% confidence interval (CI), 0.3 to 1.0; P = 0.04], whereas higher CRP levels showed trends towards fewer delirium/coma-free days (OR, 0.6; 95% CI, 0.3 to 1.1; P = 0.08). Similar relationships were found regardless of the presence of sepsis. No associations were found between procalcitonin or CRP with 28-day survival (P = 0.40 and 0.16, respectively).
conclusionsIn our pilot study, high baseline inflammatory biomarkers predicted prolonged periods of acute brain dysfunction, implicating inflammation as an important mechanism in the pathophysiology of delirium and coma during critical illness, irrespective of whether patients had sepsis or not.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.