Document Type : Original article
Authors
1
Clinical Trial dept., Research unit and drug discovery, ELRIAH, Mansoura, Egypt. Microbiology division, HTI of Applied Health Sciences, ELRIAH, Mansoura, Egypt.
2
Applied Medical Chemistry dept., Medical Research Institute, Alexandria Univ., Alexandria, Egypt.
3
HIM Program, Biochemistry, Faculty of Health Science Technology, Borg El Arab Technological Univ., Alexandria, Egypt
4
Microbiology dept., Labs of Benha Univ. Hospitals, Benha, Egypt.
5
Tropical Medicine dept., Mansoura Univ., Mansoura, Egypt. Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt
6
Internal Medicine dept., Faculty of Medicine, Hours Univ., New Damietta, Egypt.
7
Medical Surgical Nursing, Faculty of Nursing Mansoura Univ. Mansoura, Egypt.
8
Internal 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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