Diagnostic performance of different scores for predicting spontaneous bacterial peritonitis in cirrhotic patients | ||||
| Microbes and Infectious Diseases | ||||
| Articles in Press, Accepted Manuscript, Available Online from 24 December 2024 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mid.2024.339642.2367 | ||||
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| Authors | ||||
Amira Maher   1; Haitham Mohammad Al –Amir Shahat Attia2; Shimaa Anwar Rashed3; Nesreen Ali Mohammed4; Noha Saber Shafik 5; Reem M. Makbol6
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| 1Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University, Egypt | ||||
| 2Internal Medicine Department, Faculty of Medicine, Sohag University, Egypt | ||||
| 3Clinical and Chemical Pathology Department, Faculty of Medicine, Sohag University, Egypt | ||||
| 4Public Health and Community Medicine, Faculty of Medicine, Sohag University, Egypt | ||||
| 5Medical Microbiology and Immuonology, faculty of medicine, Sohag university, Egypt | ||||
| 6Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Sohag University, Egypt | ||||
| Abstract | ||||
| Background: Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotic patients with ascites. Numerous scores were proposed for SBP diagnosis with variable accuracies. Aim: To evaluate the diagnostic accuracy of procalcitonin (PCT), neutrophil/lymphocyte ratio (NLR), PCT, erythrocyte sedimentation rate, and C-reactive protein index (PEC index), and modified Wehmeyer and Mansoura scoring systems for SBP in cirrhotic patients with ascites. Methods: This cross-sectional hospital-based study included 81 adult cirrhotic patients with ascites admitted to the Tropical Medicine and Gastroenterology Department, Sohag University Hospital. Ten ml of fresh venous blood was obtained to assess serum PCT, complete blood count (CBC), transaminases, and prothrombin time (PT). NLR, PEC index, modified Wehmeyer, and Mansoura scoring systems were calculated and the Receiver Operator Curve (ROC) was used to evaluate their diagnostic accuracy for SBP. Results: SBP was diagnosed in 25 patients (30.68%). Fever, diarrhea, abdominal pain, and jaundice were significantly higher in SBP (p < 0.001, <0.001, 0.046, 0.018). The area under the ROC curve (AUC) of neutrophil/lymphocyte ratio (NLR), PEC index, Mansoura score, and Model of End Stage Liver Disease (MELD) score for SBP diagnosis was 0.7 at cutoff values of 3.6, 19.3, 3, and 17, respectively (p< 0.05). Conclusions: Regarding the scores that were compared, the NLR proved to have the highest sensitivity in identifying SBP, while the Mansoura score was the most specific. Risk factors like fever, diarrhea, abdominal pain, and high serum bilirubin were positively related to SBP. | ||||
| Keywords | ||||
| Liver cirrhosis; Spontaneous bacterial peritonitis; Mansoura score; PEC index | ||||
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