2014, Number 5
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Ann Hepatol 2014; 13 (5)
Ultra-sensitive procalcitonin may help rule out bacterial infections in patients with cirrhosis
Marciano S, Haddad L, Martínez AP, Posadas ML, Piñero F, Mora GJ, Guerrero LN, Ridruejo E, Mandó OG, Giunta DH, Gadano AC
Language: English
References: 33
Page: 541-547
PDF size: 104.28 Kb.
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.
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