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J Clin Gastroenterol. 2014 May-Jun;48(5):444-9. doi: 10.1097/MCG.0b013e3182a6cdef.

High-sensitivity C-reactive protein level is an independent predictor of poor prognosis in cirrhotic patients with spontaneous bacterial peritonitis.

Author information

1
*Department of Internal Medicine †Liver Research Institute, Seoul National University College of Medicine ‡Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea.

Abstract

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
DOI:
10.1097/MCG.0b013e3182a6cdef
[Indexed for MEDLINE]

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