INVESTIGADORES
MARCIANO Sebastian
artículos
Título:
Ultra-sensitive procalcitonin may help rule out bacterial infections in patients with cirrhosis
Autor/es:
SEBASTIAN MARCIANO; HADDAD L; MARTÍNEZ AP; MARIA LOURDES POSADAS MARTINEZ; PIÑERO F; MORA GJ; GUERRERO LN; RIDRUEJO E; MANDÓ OG; DIEGO GIUNTA; ADRIAN GADANO
Revista:
ANNALS OF HEPATOLOGY
Editorial:
MEXICAN ASSOC HEPATOLOGY
Referencias:
Año: 2014 p. 541 - 547
ISSN:
1665-2681
Resumen:
BACKGROUND:Bacterial infections are frequent complications in patients with cirrhosis. Since they are associated with poor outcomes, antibiotics are frequently over-prescribed. Surrogate markers of bacterial infections, like procalcitonin, are needed to better discriminate between infected and not infected patients.AIMS:To evaluated the diagnostic accuracy of an ultra-sensitive procalcitonin assay for the diagnosis of bacterial infections in patients with cirrhosis.MATERIAL AND METHODS:In a single-center prospective study, we determined the basal levels of procalcitonin in 106 episodes of admissions to the emergency department in 84 cirrhotic patients. Patients were classified as infected or not infected by two independent hepatologists blinded to the procalcitonin result.RESULTS:The prevalence of bacterial infection was 28% (29 episodes). The median procalcitonin was significantly higher in the infected group than in the not infected group (0.45 vs. 0.061 ng/mL, p < 0.001). The diagnostic accuracy of procalcitonin for bacterial infection estimated by the ROC curve was 0.95 (CI: 95%, 0.91-0.99). When selecting a cutoff value of 0.098 ng/mL a sensitivity of 97% and a negative predictive value 98% were found.CONCLUSIONS:The use of an ultra-sensitive procalcitonin assay identifies patients with cirrhosis at very low risk of bacterial infections.