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399818

C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites

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Last updated: 03 Jan 2025

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Abstract

Background and aim. Spontaneous bacterial peritonitis (SBP) is a severe infection in cirrhotic patients with ascites causing high morbidity and mortality. Recurrent SBP is a significant concern due to the lack of reliable predictors. This study pro-poses a composite score using C-reactive protein (CRP) and serum albumin levels as potential biomarkers for predicting SBP recurrence in cirrhotic patients. Methods. The study involved 318 patients with ascites who experienced their first episode of SBP. Data on demographics, clinical features and laboratory results, including CRP and albumin levels, were collected. The predictive accuracy of the score was assessed using receiver operating characteristic curve (AUC) analysis and multivariate logistic regression. Results. Out of 318 included in study, 254 had continued the study. During the follow-up, 58 patients (22.84%) had recurrent SBP while 196 patients (77.16%) did not. Patients with recurrent SBP had higher CRP and lower albumin levels compared to those wit-hout recurrent SBP with p < 0.001 for both. The composite CRP to albumin score was significantly higher in the recurrent SBP group (p=0.003). The ROC analysis indicated that a cut-off score of ≥3 had 80% sensitivity and 72% specificity (AUC = 0.84, p < 0.001) for predicting recurrent SBP. Multivariate logistic regression analysis identified the CRP to albumin score, age, presence of diabetes, and renal dysfunction as significant predictors of SBP recurrence. Conclusions. The CRP to albumin composite score is a promising tool for predicting SBP recurrence in cirrhotic patients, with high sensitivity and specificity.

DOI

10.21608/mjvh.2024.399818

Keywords

Spontaneous Bacterial Peritonitis, C-reactive protein, albumin, C-reactive protein to albumin score, ascites, Cirrhosis Score

Authors

First Name

Alaa

Last Name

Elmetwalli

MiddleName

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Affiliation

Clinical Trial dept., Research unit and drug discovery, ELRIAH, Mansoura, Egypt. Microbiology division, HTI of Applied Health Sciences, ELRIAH, Mansoura, Egypt.

Email

dr.prof2011@gmail.com

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-

Orcid

0000-0001-5371-4297

First Name

Jihan

Last Name

Hassan

MiddleName

-

Affiliation

Applied Medical Chemistry dept., Medical Research Institute, Alexandria Univ., Alexandria, Egypt.

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Orcid

-

First Name

Nadia

Last Name

Ismail

MiddleName

-

Affiliation

HIM Program, Biochemistry, Faculty of Health Science Technology, Borg El Arab Technological Univ., Alexandria, Egypt

Email

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City

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Orcid

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First Name

Rania

Last Name

Rizk

MiddleName

-

Affiliation

Microbiology dept., Labs of Benha Univ. Hospitals, Benha, Egypt.

Email

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City

-

Orcid

-

First Name

Mohammed

Last Name

Abdelaziz

MiddleName

-

Affiliation

Tropical Medicine dept., Mansoura Univ., Mansoura, Egypt. Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt

Email

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City

-

Orcid

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First Name

Sherin

Last Name

Mohamed

MiddleName

-

Affiliation

Internal Medicine dept., Faculty of Medicine, Hours Univ., New Damietta, Egypt.

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City

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Orcid

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First Name

Heba

Last Name

Salama

MiddleName

-

Affiliation

Medical Surgical Nursing, Faculty of Nursing Mansoura Univ. Mansoura, Egypt.

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City

-

Orcid

-

First Name

Eman

Last Name

Abdelkader

MiddleName

-

Affiliation

Internal Medicine dept., Mansoura Univ., Mansoura, Egypt.

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-

City

-

Orcid

-

Volume

8.2

Article Issue

2

Related Issue

50386

Issue Date

2024-09-01

Receive Date

2024-11-01

Publish Date

2024-12-27

Page Start

6

Page End

8

Print ISSN

2314-8748

Online ISSN

2314-8756

Link

https://mjvh.journals.ekb.eg/article_399818.html

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https://mjvh.journals.ekb.eg/service?article_code=399818

Order

6

Type

Original article

Type Code

477

Publication Type

Journal

Publication Title

Medical Journal of Viral Hepatitis

Publication Link

https://mjvh.journals.ekb.eg/

MainTitle

C-reactive protein to albumin ratio: A new score for predicting the recurrence of spontaneous bacterial peritonitis in cirrhotic patients with ascites

Details

Type

Article

Created At

30 Dec 2024