Accuracy of Lipopolysaccharide-Binding Protein (LBP) and fibrinogen compared to C-Reactive Protein (CRP) in differentiating pneumonia from acute bronchitis in primary care

Abstract

Aims: To assess the diagnostic value of lipopolysaccharide-binding protein (LBP) and fibrinogen compared to C-reactive protein (CRP) for pneumonia in primary care patients with lower respiratory tract infection (LRTI). Methods: Receiver operating characteristic curves summarising test accuracies for LBP, fibrinogen and CRP for pneumonia were constructed. The respective areas under the curve (AUCs) were calculated and compared with that of body temperature, an acknowledged clinical sign to differentiate pneumonia from acute bronchitis in primary care. Results: 11 of 95 patients had radiographically confirmed pneumonia (11.7%). The AUC was 0.90 for CRP, 0.92 for LBP and 0.86 for fibrinogen. Body temperature yielded an AUC of 0.63. Differences between the AUCs were not significant for the three blood tests, but highly significant when compared to body temperature (p<0.001). Conclusion: LBP and fibrinogen are equally strong predictors of pneumonia in patients with LRTI, but they do not perform better than CRP. © 2009 General Practice Airways Group. All rights reserved.