Abstract
Background
Bacterial infections impair prognosis in patients with cirrhosis. Presepsin and, more
recently, resistin are promising markers of infection and sepsis in patients without
cirrhosis.
Aims
The aim of our study was to assess the performance of presepsin and resistin as early
markers of infection compared with C reactive protein (CRP) and procalcitonin (PCT),
and their prognostic relevance in patients with decompensated cirrhosis.
Methods
One hundred and fourteen consecutive patients with decompensated cirrhosis were enrolled
and followed-up for 28 days. Diagnostic performances of CRP, PCT, presepsin and resistin
were assessed.
Results
Fifty-three (46.5%) patients had bacterial infections of which 30 (56%) had sepsis.
Presepsin and resistin had similar performance as CRP and PCT for the diagnosis of
infection (best cut-off of 1444 pg/ml and 20 ng/ml, respectively) and sepsis. Presepsin
(HR = 5.5; 95%CI: 2.36–13.21, p < 0.0001) and the ≥500 pg/ml increase of presepsin
at 48 h (HR = 9.24; 95%CI: 3.66–23.27, p < 0.008) were independently associated with
28-day mortality.
Conclusions
Presepsin and resistin have similar diagnostic performances to CRP and PCT for bacterial
infection in decompensated cirrhosis. Presepsin and Δ presepsin ≥500 pg/ml have also
a prognostic relevance for 28-day mortality.
Keywords
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Article info
Publication history
Published online: June 17, 2019
Accepted:
May 20,
2019
Received:
January 10,
2019
Identification
Copyright
© 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
