Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein
Abstract Background Severe alcoholic hepatitis is a catastrophic disease with a mortality rate of up to 35–50% at 30 days. Bacterial infection is an important prognostic factor in patients with severe alcoholic hepatitis, but it is difficult to detect the presence of infection immediately. Procalcit...
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BMC
2024-11-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-024-03519-x |
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| author | Min Kyu Kang Yu Rim Lee Soo Young Park Kwang Il Seo Sang Soo Lee Byung Seok Kim Jeong Eun Song Jun Sik Yoon Young Mi Hong Ki Tae Yoon Woo Jin Chung Seung Ha Park Eunju Kim Kyung Ran Jun Jung Gil Park Yang-Hyun Baek Nae-Yun Heo |
| author_facet | Min Kyu Kang Yu Rim Lee Soo Young Park Kwang Il Seo Sang Soo Lee Byung Seok Kim Jeong Eun Song Jun Sik Yoon Young Mi Hong Ki Tae Yoon Woo Jin Chung Seung Ha Park Eunju Kim Kyung Ran Jun Jung Gil Park Yang-Hyun Baek Nae-Yun Heo |
| author_sort | Min Kyu Kang |
| collection | DOAJ |
| description | Abstract Background Severe alcoholic hepatitis is a catastrophic disease with a mortality rate of up to 35–50% at 30 days. Bacterial infection is an important prognostic factor in patients with severe alcoholic hepatitis, but it is difficult to detect the presence of infection immediately. Procalcitonin (PCT) is a well-known inflammatory marker that can detect bacterial infections in various diseases early. Therefore, we aimed to evaluate the diagnostic accuracy of PCT for bacterial infection in severe alcoholic hepatitis. Methods We prospectively enrolled patients with severe alcoholic hepatitis, defined as modified Maddrey’s Discriminant Function ≥ 32, from 10 medical centers. At admission, we performed an initial evaluation including physical examination, laboratory test, radiology, blood and urine culture, PCT, and C-reactive protein (CRP). We compared the receiver operating characteristic (ROC) curves of PCT and CRP for bacterial infection, systemic inflammatory response syndrome (SIRS), and sepsis among total patients. Results A total of 108 patients with severe alcoholic hepatitis were enrolled. The number of bacterial infections, SIRS, and sepsis were 31 (28.7%), 41 (38.0%), and 19 (17.6%), respectively. The patients with bacterial infection had significantly higher MELD scores (24.0 vs. 15.0), PCT levels (1.5 vs. 0.4 ng/mL), and CRP levels (4.9 vs. 2.5 mg/dL) compared to those without bacterial infection. The area under the ROC curve (AUROC) of PCT vs. CRP for bacterial infection was 0.752 and 0.655, respectively (P = 0.113). The AUROC of PCT vs. CRP for SIRS was 0.699 and 0.662, respectively (P = 0.490). The AUROC of PCT vs. CRP for sepsis was 0.780 and 0.630, respectively (P = 0.027). Conclusions Among patients with severe alcoholic hepatitis, PCT showed a trend of superior diagnostic performance in the early detection of bacterial infection and sepsis compared to CRP. Although PCT might have better potential to diagnose sepsis in the setting of severe alcoholic hepatitis, it is necessary to find more reliable diagnostic markers. |
| format | Article |
| id | doaj-art-6fe916be3e8a4e87ba7a371086aef727 |
| institution | OA Journals |
| issn | 1471-230X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-6fe916be3e8a4e87ba7a371086aef7272025-08-20T02:08:22ZengBMCBMC Gastroenterology1471-230X2024-11-012411910.1186/s12876-024-03519-xDiagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive proteinMin Kyu Kang0Yu Rim Lee1Soo Young Park2Kwang Il Seo3Sang Soo Lee4Byung Seok Kim5Jeong Eun Song6Jun Sik Yoon7Young Mi Hong8Ki Tae Yoon9Woo Jin Chung10Seung Ha Park11Eunju Kim12Kyung Ran Jun13Jung Gil Park14Yang-Hyun Baek15Nae-Yun Heo16Department of Internal Medicine, College of Medicine, Yeungnam UniversityDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University HospitalDepartment of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of MedicineDepartment of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon HospitalDepartment of Internal Medicine, Daegu Catholic University School of MedicineDepartment of Internal Medicine, Daegu Catholic University School of MedicineDepartment of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik HospitalDepartment of Internal Medicine, Pusan National University College of Medicine, Pusan National University Yangsan HospitalDepartment of Internal Medicine, Pusan National University College of Medicine, Pusan National University Yangsan HospitalDepartment of Internal Medicine, Keimyung University Dongsan Medical CenterDepartment of Internal Medicine, Inje University College of Medicine, Inje University Haeundae Paik HospitalDepartment of Internal Medicine, Inje University College of Medicine, Inje University Haeundae Paik HospitalDepartment of Laboratory Medicine, Inje University College of Medicine, Inje University Haeundae Paik HospitalDepartment of Internal Medicine, College of Medicine, Yeungnam UniversityDepartment of Internal Medicine, Dong-A University College of MedicineDepartment of Internal Medicine, Inje University College of Medicine, Inje University Haeundae Paik HospitalAbstract Background Severe alcoholic hepatitis is a catastrophic disease with a mortality rate of up to 35–50% at 30 days. Bacterial infection is an important prognostic factor in patients with severe alcoholic hepatitis, but it is difficult to detect the presence of infection immediately. Procalcitonin (PCT) is a well-known inflammatory marker that can detect bacterial infections in various diseases early. Therefore, we aimed to evaluate the diagnostic accuracy of PCT for bacterial infection in severe alcoholic hepatitis. Methods We prospectively enrolled patients with severe alcoholic hepatitis, defined as modified Maddrey’s Discriminant Function ≥ 32, from 10 medical centers. At admission, we performed an initial evaluation including physical examination, laboratory test, radiology, blood and urine culture, PCT, and C-reactive protein (CRP). We compared the receiver operating characteristic (ROC) curves of PCT and CRP for bacterial infection, systemic inflammatory response syndrome (SIRS), and sepsis among total patients. Results A total of 108 patients with severe alcoholic hepatitis were enrolled. The number of bacterial infections, SIRS, and sepsis were 31 (28.7%), 41 (38.0%), and 19 (17.6%), respectively. The patients with bacterial infection had significantly higher MELD scores (24.0 vs. 15.0), PCT levels (1.5 vs. 0.4 ng/mL), and CRP levels (4.9 vs. 2.5 mg/dL) compared to those without bacterial infection. The area under the ROC curve (AUROC) of PCT vs. CRP for bacterial infection was 0.752 and 0.655, respectively (P = 0.113). The AUROC of PCT vs. CRP for SIRS was 0.699 and 0.662, respectively (P = 0.490). The AUROC of PCT vs. CRP for sepsis was 0.780 and 0.630, respectively (P = 0.027). Conclusions Among patients with severe alcoholic hepatitis, PCT showed a trend of superior diagnostic performance in the early detection of bacterial infection and sepsis compared to CRP. Although PCT might have better potential to diagnose sepsis in the setting of severe alcoholic hepatitis, it is necessary to find more reliable diagnostic markers.https://doi.org/10.1186/s12876-024-03519-xAlcoholic hepatitisBacterial infectionSepsisProcalcitoninC-reactive protein |
| spellingShingle | Min Kyu Kang Yu Rim Lee Soo Young Park Kwang Il Seo Sang Soo Lee Byung Seok Kim Jeong Eun Song Jun Sik Yoon Young Mi Hong Ki Tae Yoon Woo Jin Chung Seung Ha Park Eunju Kim Kyung Ran Jun Jung Gil Park Yang-Hyun Baek Nae-Yun Heo Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein BMC Gastroenterology Alcoholic hepatitis Bacterial infection Sepsis Procalcitonin C-reactive protein |
| title | Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein |
| title_full | Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein |
| title_fullStr | Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein |
| title_full_unstemmed | Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein |
| title_short | Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein |
| title_sort | diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with c reactive protein |
| topic | Alcoholic hepatitis Bacterial infection Sepsis Procalcitonin C-reactive protein |
| url | https://doi.org/10.1186/s12876-024-03519-x |
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