EVALUATION OF PROCALCITONIN AND C-REACTIVE PROTEIN IN PATIENTS OF CIRRHOSIS OF LIVER WITH SEPSIS- A CROSS-SECTIONAL STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 47
Abstract
BACKGROUND Sepsis is commonly encountered in patients of cirrhosis of liver and is associated with worse outcome. Traditional culture methods commonly used to diagnose sepsis in such patients is positive only in 50-70% of cases and take longer time. Therefore, surrogate marker such as Procalcitonin (PCT) and C-Reactive Protein (CRP) may be useful to identify patients of early sepsis with increased sensitivity and in shorter time. The aim of the study is to- 1. Evaluate the role of PCT and CRP in patients with cirrhosis of liver with and without sepsis. 2. Find correlation of levels of procalcitonin and CRP with clinical and biochemical parameters of severity of cirrhosis as well as to find out its prognostic implications. MATERIALS AND METHODS A cross-sectional observational study was conducted in the Department of Medicine, King George Medical University, Lucknow, India, over a period of one year. A detailed history and clinical examination was performed in all enrolled patients. Along with routine tests done in patients of cirrhosis of liver, procalcitonin and CRP levels are performed. RESULTS PCT and CRP levels were significantly higher in patients with sepsis as compared to patients without sepsis. PCT and CRP levels were also significantly higher in patients who presented with complications of cirrhosis like variceal bleed, hepatic encephalopathy and severe ascites as compared to patients without these complications. Significantly higher rate of mortality and longer duration of hospital stay was observed in patients with higher values of PCT and CRP levels. CONCLUSION Procalcitonin and CRP levels are significantly raised in patients of cirrhosis with sepsis. These biomarkers gives us an opportunity to diagnose sepsis in early stages, so that early antibiotic therapy can be initiated and sepsis precipitated complications of cirrhosis can be prevented leading to favourable outcome of the patient. So, we recommend that PCT and CRP levels should always be measured in patients of cirrhosis with suspected sepsis
Authors and Affiliations
Vivek Kumar, Sudhir Kumar Verma, Dinesh Kumar Singh, Nikhil Panjabrao Joge, Ravi Misra
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