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The Role of Serum Procalcitonin Level as an Early Marker of Ascitic Fluid Infection in Post Hepatitic Cirrhotic Patients.

BACKGROUND & AIMS
The early diagnosis of spontaneous bacterial peritonitis (SBP) has been considered important in overall patient's survival. Ascitic fluid culture examination performance, in the emergency setting, is time consuming and not always available, so there is a need for easy to apply, rapid and reliable markers to predict diagnosis in patients with ascites. This present prospective study aimed to determine the early diagnostic value of serum procalcitonin (PCT) levels in decompensated cirrhotic patients (DCPs) with SBP.


METHODS
47 HCV cirrhotic patients with ascites were enrolled for this prospective study. The severity of cirrhosis was classified based on the Child-Pugh criteria. All patients were subjected to paracentesis and ascitic fluid (AF) culture. Serum PCT levels were measured using enzyme-linked fluorescence analysis (ELFA).


RESULTS
The diagnostic value of serum PCT levels and WBC/PLT ratios for detecting infections were serum PCT levels (3.63 ± 3.47 ng/mL) in DCPs with infections which was significantly higher than in DCPs without infections (0.505 ± 0.230 ng/mL); p < 0.05. The cut-off value for serum PCT levels was 0.7 ng/mL for the diagnosis of infections in DCPs, for which the sensitivity and specificity were 93.1% and 73.2%, respectively. The AUC was 0.91 (95% CI: 0.83-0.99).


CONCLUSIONS
Serum procalcitonin seems to provide satisfactory diagnostic biomarkers in SBP.