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Are presepsin and resistin better markers for bacterial infection in patients with decompensated liver cirrhosis?
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2019 Dec; Vol. 51 (12), pp. 1685-1691. Date of Electronic Publication: 2019 Jun 17. - Publication Year :
- 2019
-
Abstract
- Background: Bacterial infections impair prognosis in patients with cirrhosis. Presepsin and, more recently, resistin are promising markers of infection and sepsis in patients without cirrhosis.<br />Aims: The aim of our study was to assess the performance of presepsin and resistin as early markers of infection compared with C reactive protein (CRP) and procalcitonin (PCT), and their prognostic relevance in patients with decompensated cirrhosis.<br />Methods: One hundred and fourteen consecutive patients with decompensated cirrhosis were enrolled and followed-up for 28 days. Diagnostic performances of CRP, PCT, presepsin and resistin were assessed.<br />Results: Fifty-three (46.5%) patients had bacterial infections of which 30 (56%) had sepsis. Presepsin and resistin had similar performance as CRP and PCT for the diagnosis of infection (best cut-off of 1444 pg/ml and 20 ng/ml, respectively) and sepsis. Presepsin (HR = 5.5; 95%CI: 2.36-13.21, p < 0.0001) and the ≥500 pg/ml increase of presepsin at 48 h (HR = 9.24; 95%CI: 3.66-23.27, p < 0.008) were independently associated with 28-day mortality.<br />Conclusions: Presepsin and resistin have similar diagnostic performances to CRP and PCT for bacterial infection in decompensated cirrhosis. Presepsin and Δ presepsin ≥500 pg/ml have also a prognostic relevance for 28-day mortality.<br /> (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Biomarkers analysis
C-Reactive Protein analysis
Clinical Deterioration
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Procalcitonin analysis
Prognosis
Acute-On-Chronic Liver Failure blood
Acute-On-Chronic Liver Failure etiology
Bacterial Infections blood
Bacterial Infections complications
Bacterial Infections diagnosis
Lipopolysaccharide Receptors analysis
Liver Cirrhosis blood
Liver Cirrhosis diagnosis
Liver Cirrhosis physiopathology
Peptide Fragments analysis
Resistin analysis
Sepsis blood
Sepsis complications
Sepsis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 51
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 31221548
- Full Text :
- https://doi.org/10.1016/j.dld.2019.05.025