Usefulness of procalcitonin for diagnosing infection in critically ill patients with liver cirrhosis

Autores de IIS La Fe

• Esther Villarreal Tello

  Autor

• Mónica Gordón Sahuquillo

  Autor

• Cristina Calabuig Guillen

  Autor

• Rosario Alonso Estellés

  Autor

• Jesús Ruiz Ramos

  Autor

• Pedro Kot Baixauli

  Autor

• Paula Ramírez Galleymore

  Autor

Participantes ajenos a IIS La Fe

• Vacacela K
• Babiloni D

Grupos

• Farmacogenética

  Investigador Principal

  María José Herrero Cervera

• Infecciones Respiratorias

  Investigador Principal

  Raúl Méndez Ocaña

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

  Investigador establecido

  Marta Montero Alonso

• Medicina Intensiva

  Leader

  Álvaro Castellanos Ortega

Abstract

Objective: To evaluate the usefulness of procalcitonin (PCT) for diagnosing infection in patients with liver cirrhosis admitted to an Intensive Care Unit. Design: A retrospective study was carried out. Scope: Intensive Care Unit. Versatile, twenty-four beds. Participants Patients with liver cirrhosis admitted to our Intensive Care Unit in the last four years with suspected infection and measurement of PCT. Results: Among the 255 patients with cirrhosis admitted to our unit, PCT was determined for the differential diagnosis of infection in 69 cases (27%). Three patients were excluded from analysis due to a lack of clinical data. The average stay was 10.6 +/- 9.2 days, with a mortality rate of 65%. The origin of cirrhosis was mainly viral (57%) or alcoholic (37%). The Child-Pugh and MELD scores were 9.5 +/- 2 and 23 +/- 1 8, respectively. Infection was diagnosed in 54 patients (82%). The most common infection was pneumonia (72%), followed by intraabdominal infections (18%) and bacteremia (5%). In patients without infection, the median PCT concentration was 0.57 ng/ml (range 0.28 to 1.14) versus 2.99 (1.31 to 9.4) in those with infection (p<.001). Diagnostic capacity was maintained in patients with intraabdominal infections. The diagnostic cutoff point was set at 0.8 ng/ml (sensitivity 83%, specificity 75%, AUC 0.82 [0.702-0.93]). Conclusions: In patients with liver cirrhosis, PCT is useful for identifying bacterial infections, including intraabdominal processes: (C) 2015 Elsevier Espana, S.L.U. and SEMICYUC. All rights reserved.

Keywords

• Procalcitonin; Liver cirrhosis; Infection; Peritonitis