Cardiopulmonary hemodynamics and C-reactive protein as prognostic indicators in compensated and decompensated cirrhosis

Serum C-reactive protein is a marker of systemic inflammation, which has been studied to predict mortality and cirrhosis related complication in decompensated cirrhosis of liver. To evaluate the role of serum C- reactive protein as a predictor of early mortality in patients with decompensated cirrhosis of liver. This was a prospective observational study, carried out in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka between October 2017 to February 2019. A total of 89 patients with decompensated cirrhosis of liver were included in the study. Baseline serum CRP was measured and patients were longitudinally followed for a period of 30 days. Patients were divided into two groups, survival and non-survival. The groups were compared of CRP level, CTP score, MELD score and cirrhosis related complications. Chi-Square test was used to analyze the categorical variables and Student t-test was used to analyze continuous variables. Receiver-operator characteristic curve was used to detect serum CRP level for prediction of mortality within 30 days. The mean age was found 49.02±13.90 years in survival group and 47.52±11.30 years in non-survival group. Male patients were predominant in both groups. Total WBC count, serum CRP, serum sodium, serum bilirubin, CTP score & MELD score were statistically significant (p<0.05) between the groups. In multivariate analysis, only serum CRP level (OR 1.075, 95% CI, 1.027-1.122%, p=0.001) was found significantly associated with mortality within 30 days. Receiver-operator characteristic (ROC) was constructed, using serum CRP level, which gave a cut off value of 31mg/L, with 78% sensitivity and 90% specificity for prediction of mortality within 30 days. Elevated serum CRP level is an independent predictor of early mortality in patients with decompensated cirrhosis of liver. It was also observed that, high serum CRP level was associated with increased frequency of cirrhosis related complications. Bangladesh Med J. 2020 Jan; 49 (1): 1-6

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The Diagnostic and Prognostic Values of C-Reactive Protein and Procalcitonin during Bacterial Infections in Decompensated Cirrhosis

Gastroenterology Research and Practice ◽

10.1155/2018/5915947 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Sana Khedher ◽

Nasreddine Fouthaili ◽

Amira Maoui ◽

Sirine Lahiani ◽

Mohamed Salem ◽

...

Keyword(s):

Prognostic Value ◽

Bacterial Infections ◽

Serum Levels ◽

Decompensated Cirrhosis ◽

C Reactive Protein ◽

Reactive Protein ◽

Early Markers ◽

Cirrhotic Patients ◽

Wbc Count ◽

Sensitive Marker

Background. Bacterial infection (BI) represents the main cause of decompensation and death in cirrhotic patients. Procalcitonin (PCT) and C-reactive protein (CRP) are two widely used biomarkers that may be helpful for early detection of BI especially in the presence of inflammation. Their accuracy for the diagnosis of BI in patients with chronic liver disease has been a subject of debate. In this study, we aimed to learn whether PCT and CRP would be helpful as early markers of BI in patients with cirrhosis and to evaluate their prognostic value in terms of mortality. Subjects and Methods. We retrospectively included 92 adult patients with decompensated cirrhosis. PCT and CRP plasma levels were obtained within the first 24 hours of admission. Their diagnostic and prognostic values were compared using the appropriate statistical analysis. Results. Ninety-two patients were included. BI was diagnosed in 60 patients (65%). Mean white blood cell (WBC) count (p=0.005) and PCT and CRP serum levels (p<0.001) were higher in the BI group than in the non-BI (NBI) group. The diagnostic accuracy of CRP and PCT for the diagnosis of BI was better than that of WBC. CRP was the most sensitive marker (70%) while PCT was the more specific (96.6%). No one of those biomarkers was predictive of 3-month mortality in patients with BI. Conclusion. Regarding BI in patients with decompensated cirrhosis, CRP maintains efficiency slightly higher than that of the PCT without being discriminative. However, no prognostic value has been established for these markers.

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