Are presepsin and resistin better markers for bacterial infection in patients with decompensated liver cirrhosis?
Acute-On-Chronic Liver Failure
/ blood
Bacterial Infections
/ blood
Biomarkers
/ analysis
C-Reactive Protein
/ analysis
Clinical Deterioration
Female
Humans
Lipopolysaccharide Receptors
/ analysis
Liver Cirrhosis
/ blood
Male
Middle Aged
Peptide Fragments
/ analysis
Predictive Value of Tests
Procalcitonin
/ analysis
Prognosis
Resistin
/ analysis
Sepsis
/ blood
C-reactive protein
Procalcitonin
Prognosis
Sepsis
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
10
01
2019
revised:
17
05
2019
accepted:
20
05
2019
pubmed:
22
6
2019
medline:
22
5
2020
entrez:
22
6
2019
Statut:
ppublish
Résumé
Bacterial infections impair prognosis in patients with cirrhosis. Presepsin and, more recently, resistin are promising markers of infection and sepsis in patients without cirrhosis. 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. 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. 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. 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.
Sections du résumé
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.
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.
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.
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.
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.
Identifiants
pubmed: 31221548
pii: S1590-8658(19)30626-7
doi: 10.1016/j.dld.2019.05.025
pii:
doi:
Substances chimiques
Biomarkers
0
Lipopolysaccharide Receptors
0
Peptide Fragments
0
Procalcitonin
0
Resistin
0
presepsin protein, human
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1685-1691Informations de copyright
Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.