Procalcitonin in liver dysfunction — Dr Jekyll or Mr Hyde?

Woźnica, Ewa; Łysenko, Lidia

doi:10.5603/ait.a2018.0023

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Interestingly, signi cantly higher levels of PCT were observed in the SALD group compared to the no-SALD group (3.99 vs 28.0 ng/ml). Even though there was no correlation between PAI-1 and PCT in our study group, it has been shown in an in vitro study on a human hepatocyte model that high concentrations of procalcitonin might impair the hepatocytes function and lead to liver injury [33,34].…”

Section: Resultscontrasting

confidence: 67%

The role of Plasminogen Activator Inhibitor 1 in predicting sepsis-associated liver dysfunction: an observational study

Woźnica-Niesobska

Leśnik

Woźnica³

et al. 2021

Preprint

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Background: Sepsis-associated liver dysfunction (SALD) is associated with poor prognosis and increased mortality in the Intensive Care Unit. Bilirubin is one of the components of Sequential Organ Failure Assessment used in Sepsis-3 criteria. Hyperbilirubinemia is a late and non-specific symptom of liver dysfunction. The aim of the study was to identify plasma biomarkers, which could be used for the early diagnosis of SALD.Methods: A single-centre, prospective observational study was conducted in the ICU of Wroclaw University Hospital. Plasma biomarkers - prothrombin time, INR, antithrombin III, bilirubin, aspartate transaminase (AST), alanine transaminase, alkaline phosphatase, gamma glutamyl transferase, albumin, endothelin-1, hepcidin, plasminogen activator inhibitor-1 (PAI-1), thrombin-antithrombin complex and interferon-gamma inducible protein 10 kDa were analysed. Plasma samples were obtained from eligible septic patients within 24 hours after having developed sepsis/septic shock. Enrolled patients were followed for 14 days for developing SALD and 28 days for overall survival.Results: 79 patients were enrolled in the study, and 24 (30.4%) of them developed SALD. PAI-1 with a cut-off value of 9ng/ml was shown to be a predictor of SALD (AUC=0.727, sensitivity 79.2%; specificity 41.8%; accuracy 53.2%) and of 28-day survival in patients with sepsis/septic shock (log rank test, p=0.00091). This was also useful in predicting 28-day survival, in combination with AST (log rank test, p=0.00242).Conclusions: Sepsis-associated hyperbilirubinemia is frequent, but bilirubin is a late and non-specific marker of SALD. Measuring PAI-1 serum levels at the onset of sepsis/ septic shock may be useful in predicting the development of SALD. A combination of PAI-1 and AST better predicts the 28-day survival than PAI-1 alone, but due to the low cut-off values of AST, this might not be clinically significant.

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Section: Resultscontrasting

confidence: 67%

The role of Plasminogen Activator Inhibitor 1 in predicting sepsis-associated liver dysfunction: an observational study

Woźnica-Niesobska

Leśnik

Woźnica³

et al. 2021

Preprint

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“…PCT has been questioned as an index of bacterial infection in patients with liver diseases as several studies have demonstrated elevated PCT levels in the absence of bacterial infection in such patients[ 18 , 27 , 28 ]. We previously showed that PCT was not the best parameter of infection in cirrhotic patients following the onset of sepsis[ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a novel score for the diagnosis of bacterial infection in patients with acute-on-chronic liver failure

Lin

Yan

et al. 2020

WJG

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BACKGROUND The diagnosis of bacterial infection is difficult in patients with acute-on-chronic liver failure (ACLF). AIM To evaluate the diagnostic accuracy of widely used parameters for bacterial infection in ACLF and to develop a simple scoring system to improve diagnostic efficiency. METHODS This was a retrospective study. Procalcitonin (PCT), white blood cells (WBC), proportion of neutrophils (N%), and C-reactive protein (CRP) were examined. Logistic regression was used to select variables for the scoring models and receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnostic value of different indices. RESULTS This study included 386 patients with ACLF, 169 (43.78%) of whom had bacterial infection on admission. The area under the ROC (AUROC) of PCT, CRP, WBC and N% for the diagnosis of bacterial infection ranged from 0.637 to 0.692, with no significant difference between them. Logistic regression showed that only N%, PCT, and CRP could independently predict infection. A novel scoring system (infection score) comprised of N%, PCT and CRP was developed. The AUROC of the infection score was 0.740, which was significantly higher than that for the other four indices (infection score vs N%, PCT, CRP, and WBC, P = 0.0056, 0.0001, 0.0483 and 0.0008, respectively). The best cutoff point for the infection score was 4 points, with a sensitivity of 78.05%, a specificity of 55.29%, a positive predictive value of 57.91% and a negative predictive value of 76.16%. CONCLUSION The infection score is a simple and useful tool for discriminating bacterial infection in ACLF.

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Procalcitonin in liver dysfunction — Dr Jekyll or Mr Hyde?

Cited by 2 publications

References 29 publications

The role of Plasminogen Activator Inhibitor 1 in predicting sepsis-associated liver dysfunction: an observational study

The role of Plasminogen Activator Inhibitor 1 in predicting sepsis-associated liver dysfunction: an observational study

Development of a novel score for the diagnosis of bacterial infection in patients with acute-on-chronic liver failure

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