Background and study aim: Bacterial infections mess up prognosis of cirrhotic patients. Presepsin and resistin are favorable infection markers that can help in diagnosis of such condition. This study aimed to assess performance of presepsin and resistin in diagnosis of infection compared with C reactive protein (CRP) and procalcitonin (PCT) among patients with decompensated cirrhosis.
Patients and Methods: Two hundred and thirteen patients with decompensated cirrhosis admitted to Internal Medicine hospital, Zagazig University, were included in this study. All patients underwent history taking, thorough clinical examination and laboratory investigations including measuring CRP, PCT, presepsin and resistin.
Results: About 47% of patients have infections. Presepsin and resistin were significantly higher among patients with infection and positively correlated with Model for End-stage Liver Disease score (MELD), Child-pough score (CPS), CRP and PCT. Presepsin cutoff≥1205 pg/ml could predict infection at sensitivity 83.8%, specificity 93% and accuracy 88.7%. Resistin cutoff≥21 ng/ml could predict infection at sensitivity 64.6%, specificity 68.4% and accuracy 66.7%. Adding CRP to PCT or presepsin increased sensitivity to 99%, specificity 73.7%, and accuracy 85.4%. Adding presepsin to PCT or resistin increased sensitivity to 94.9%. Yet combined presepsin and PCT had higher specificity than combined presepsin and resistin.
Conclusion: Presepsin has comparable diagnostic performances to CRP and PCT for bacterial infection in decompensated cirrhosis while resistin has poor sensitivity and specificity. Adding presepsin to CRP yields the same diagnostic performance as combined CRP and PCT. So, combining any of them to CRP helps to early diagnose bacterial infection in those patients