High-sensitivity C-reactive Protein Level is an Independent Predictor of Poor Prognosis in Cirrhotic Patients With Spontaneous Bacterial Peritonitis.
J Clin Gastroenterol. 2013 Sep 16;
Authors: Cho Y, Park SY, Lee JH, Lee DH, Lee M, Yoo JJ, Choi WM, Cho YY, Lee YB, Yoon JW, Kwon JH, Cho EJ, Yu SJ, Kim YJ, Yoon JH, Kim CY, Lee HS
BACKGROUND/AIMS:: The production of high-sensitivity C-reactive protein (hs-CRP) may be affected by hepatic function, and the clinical importance of hs-CRP in patients with liver cirrhosis is still not clear. The aim of this study was to evaluate the clinical implications of hs-CRP in cirrhotic patients with spontaneous bacterial peritonitis (SBP).
METHODS:: We retrospectively investigated 336 consecutive patients treated for SBP from 2007 to 2012. The relationship between serum hs-CRP and the result of the treatment was assessed.
RESULTS:: A response to antibiotics was observed in 182 patients (54.2%), and 126 patients (37.5%) died of SBP. The initial hs-CRP (odds ratio=1.061, P=0.016), coexistent hepatocellular carcinoma, and Child-Pugh (CP) score were independent prognostic factors for high in-hospital mortality. Serum hs-CRP level was also an independent predictor of lower antibiotic response rate (odds ratio=0.916, P<0.001). However, hs-CRP was negatively correlated with the CP score (r=-0.199, P<0.001) and Model for End-Stage Liver Disease score (r=-0.182, P=0.001).
CONCLUSIONS:: This study found that serum hs-CRP level is related to a lower response rate to antibiotics, a higher mortality rate in patients with SBP. The hs-CRP level was negatively correlated with the CP and Model for End-Stage Liver Disease scores, which suggests that the prognostic function of hs-CRP was not a surrogate for hepatic dysfunction.
PMID: 24045283 [PubMed - as supplied by publisher]