Elmetwalli, A., Hassan, J., Ismail, N., Rizk, R., Abdelaziz, M., Mohamed, S., Salama, H., Abdelkader, E. (2024). C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites. Medical Journal of Viral Hepatitis, 8.2(2), 6-8. doi: 10.21608/mjvh.2024.399818
Alaa Elmetwalli; Jihan Hassan; Nadia Ismail; Rania Rizk; Mohammed Abdelaziz; Sherin Mohamed; Heba Salama; Eman Abdelkader. "C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites". Medical Journal of Viral Hepatitis, 8.2, 2, 2024, 6-8. doi: 10.21608/mjvh.2024.399818
Elmetwalli, A., Hassan, J., Ismail, N., Rizk, R., Abdelaziz, M., Mohamed, S., Salama, H., Abdelkader, E. (2024). 'C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites', Medical Journal of Viral Hepatitis, 8.2(2), pp. 6-8. doi: 10.21608/mjvh.2024.399818
Elmetwalli, A., Hassan, J., Ismail, N., Rizk, R., Abdelaziz, M., Mohamed, S., Salama, H., Abdelkader, E. C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites. Medical Journal of Viral Hepatitis, 2024; 8.2(2): 6-8. doi: 10.21608/mjvh.2024.399818
C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites
1Clinical Trial dept., Research unit and drug discovery, ELRIAH, Mansoura, Egypt. Microbiology division, HTI of Applied Health Sciences, ELRIAH, Mansoura, Egypt.
2Applied Medical Chemistry dept., Medical Research Institute, Alexandria Univ., Alexandria, Egypt.
3HIM Program, Biochemistry, Faculty of Health Science Technology, Borg El Arab Technological Univ., Alexandria, Egypt
4Microbiology dept., Labs of Benha Univ. Hospitals, Benha, Egypt.
5Tropical Medicine dept., Mansoura Univ., Mansoura, Egypt. Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt
6Internal Medicine dept., Faculty of Medicine, Hours Univ., New Damietta, Egypt.
7Medical Surgical Nursing, Faculty of Nursing Mansoura Univ. Mansoura, Egypt.
8Internal Medicine dept., Mansoura Univ., Mansoura, Egypt.
Abstract
Background and aim. Spontaneous bacterial peritonitis (SBP) is a severe infection in cirrhotic patients with ascites causing high morbidity and mortality. Recurrent SBP is a significant concern due to the lack of reliable predictors. This study pro-poses a composite score using C-reactive protein (CRP) and serum albumin levels as potential biomarkers for predicting SBP recurrence in cirrhotic patients. Methods. The study involved 318 patients with ascites who experienced their first episode of SBP. Data on demographics, clinical features and laboratory results, including CRP and albumin levels, were collected. The predictive accuracy of the score was assessed using receiver operating characteristic curve (AUC) analysis and multivariate logistic regression. Results. Out of 318 included in study, 254 had continued the study. During the follow-up, 58 patients (22.84%) had recurrent SBP while 196 patients (77.16%) did not. Patients with recurrent SBP had higher CRP and lower albumin levels compared to those wit-hout recurrent SBP with p < 0.001 for both. The composite CRP to albumin score was significantly higher in the recurrent SBP group (p=0.003). The ROC analysis indicated that a cut-off score of ≥3 had 80% sensitivity and 72% specificity (AUC = 0.84, p < 0.001) for predicting recurrent SBP. Multivariate logistic regression analysis identified the CRP to albumin score, age, presence of diabetes, and renal dysfunction as significant predictors of SBP recurrence. Conclusions. The CRP to albumin composite score is a promising tool for predicting SBP recurrence in cirrhotic patients, with high sensitivity and specificity.
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