Ultra-sensitive procalcitonin may help rule out bacterial infections in patients with cirrhosis
Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 5
Abstract
Background. Bacterial infections are frequent complications in patients with cirrhosis. Since they are associated with poor outcomes, antibiotics are frequently over-prescribed. Surrogate markers of bacterial infections, like procalcitonin, are needed to better discriminate between infected and not infected patients. Aims. To evaluated the diagnostic accuracy of an ultra-sensitive procalcitonin assay for the diagnosis of bacterial infections in patients with cirrhosis. Material and methods. In a single-center prospective study, we determined the basal levels of procalcitonin in 106 episodes of admissions to the emergency department in 84 cirrhotic patients. Patients were classified as infected or not infected by two independent hepatologists blinded to the procalcitonin result. Results. The prevalence of bacterial infection was 28% (29 episodes). The median procalcitonin was significantly higher in the infected group than in the not infected group (0.45 vs. 0.061 ng/mL, p < 0.001). The diagnostic accuracy of procalcitonin for bacterial infection estimated by the ROC curve was 0.95 (CI: 95%, 0.91-0.99). When selecting a cutoff value of 0.098 ng/mL a sensitivity of 97% and a negative predictive value 98% were found. Conclusions. The use of an ultra-sensitive procalcitonin assay identifies patients with cirrhosis at very low risk of bacterial infections.
Authors and Affiliations
Sebastián Marciano, Leila Haddad, Alfredo Pedro Martínez, María L. Posadas, Federico Piñero, Gonzalo J. Mora, Laura N. Guerrero, Ezequiel Ridruejo, Oscar G. Mandó, Diego H. Giunta, Adrián C. Gadano
Keywords
Related Articles
- EP ID EP78438
- DOI -
- Views 136
- Downloads 0
Adult live donor liver transplantation: routine, commonplace, standard care for end stage liver disease (we hope)
Use of acetylcysteine for non-acetaminophen-induced acute liver failure
The purpose of this review was to evaluate the effectiveness of acetylcysteine in the treatment of acute liver failure not related to acetaminophen. A search of MEDLINE April 2003 through May 2012 using the Pub Med datab...
Non-neoplastic Portal Vein Thrombosis in HCV Cirrhosis Patients: Is it an Immuno-Inflammatory Disorder?
Background and aims. Portal vein thrombosis (PVT) is a critical complication in cirrhotic patients. We explored the role of the activated factor VII-antithrombin (FVIIa-AT) complex and enhanced monocytic tissue factor (T...
A New Stage in Annals of Hepatology
-<br/><br/>
The relation of fibrosis stage with nutritional deficiencies and bioelectrical impedance analysis of body composition in patients with chronic hepatitis C
Background. Nutritional deficiencies may aggravate the course of chronic hepatitis C (CHC). Our aim has been to perform a comprehensive analysis of body composition and nutritional deficiencies in CHC patients in non-ci...