An exploratory study of ascitic fluid lactate as prognostic factor of mortality in cirrhotic patients with spontaneous bacterial peritonitis

Mani, Iliana; Alexopoulos, T.; Hadziyannis, Emilia; Tsiriga, Athanasia; Vourli, Georgia; Alexopoulou, Αlexandra

doi:10.1097/meg.0000000000002332

Cited by 4 publications

(11 citation statements)

References 35 publications

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“…Of 14 studies, six studies were on infection with 2786 hospitalized cirrhotic patients, of whom 934 developed infection [ 18 , 20 – 22 , 24 , 26 ]. Others were on SBP with 1573 cirrhotic patients with ascites, of whom 557 developed SBP [ 14 – 17 , 19 , 23 , 25 , 27 ]. The process of inclusion and exclusion is detailed in the PRISMA flow diagram, which is provided in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies were included in our systematic review and meta-analysis [ 14 – 27 ]. Seven studies were prospective [ 15 – 17 , 19 , 20 , 23 , 25 ] and others were retrospective [ 14 , 18 , 21 , 22 , 24 , 26 , 27 ]. All of them were written in English.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, two of these included studies further assessed the prognostic capacity of NLR, both finding differences in SBP patients with and without mortality [ 19 , 23 ]. Illiaz and colleagues demonstrated that the NLR was useful in predicting 30-day and 3-month mortality.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 960 records were retrieved in the database search and manual search of the citation list of articles. After the exclusion of duplicates and not relevant records, 14 studies were included in the systematic review and meta-analysis [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Of 14 studies, six studies were on infection with 2786 hospitalized cirrhotic patients, of whom 934 developed infection [18, 20-22, 24, 26].…”

Section: Search and Selection Of Literaturementioning

confidence: 99%

“…e overall study quality ranged from 6 to 8 stars. Fourteen studies were included in our systematic review and meta-analysis [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Seven studies were prospective [15-17, 19, 20, 23, 25] and others were retrospective [14,18,21,22,24,26,27].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis

Seyedi¹,

Nabipoorashrafi²,

Hernandez

et al. 2022

Canadian Journal of Gastroenterology and Hepatology

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Background. The goal of this systematic review and meta-analysis was analyzing published studies on the role of neutrophil to lymphocyte ratio (NLR) in infection and spatially spontaneous bacterial peritonitis (SBP) among cirrhotic patients. Methods. PubMed, Web of Science, and Scopus were searched until May 24, 2022. The Newcastle–Ottawa scale was used for quality assessment. Results. Of 14 studies included in our study, six studies were on infection with 2786 hospitalized cirrhotic patients, of whom 934 developed an infection. Other studies were on SBP with 1573 cirrhotic patients with ascites, of whom 557 developed SBP. The pooled results showed that there was no difference in NLR levels between hospitalized cirrhotic patients who developed infection compared to those who did not (random-effects model: SMD = 0.63, 95% CI = −0.01–1.27, p = 0.054 ). However, cirrhotic patients with ascites who developed SBP had elevated levels of NLR compared to those who did not (random-effects model: SMD = 1.05, 95% CI = 0.52–1.57, p < 0.001 ). This difference remained significant in prospective studies (SMD = 0.94, 95% CI = 0.51–1.38, p < 0.001 ) but not in retrospective studies (SMD = 1.37, 95% CI = −0.56–3.29, p = 0.165 ), in the subgroup analysis according to the study design. The pooled sensitivity of NLR was 92.07% (95% CI = 74.85%–97.84%) and the pooled specificity was 72.58% (95% CI = 57.72%–83.69%). The pooled positive likelihood ratio, negative likelihood ratio, DOR of NLR were 3.35(95%CI = 2.06–5.46), 0.10 (95%CI = 0.03–0.38), and 30.78 (95%CI = 7.01–135.04), respectively. Conclusion. Our results support NLR to be a valid biomarker that can be readily integrated into clinical settings to help in the prevention and prediction of SBP among cirrhotic patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Search and Selection Of Literaturementioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis

Seyedi¹,

Nabipoorashrafi²,

Hernandez

et al. 2022

Canadian Journal of Gastroenterology and Hepatology

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Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes

Du,

Li,

Jiang

et al. 2023

BMC Infect Dis

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Background Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis. The diagnosis of SBP is still mostly based on ascites cultures and absolute ascites polymorphonuclear (PMN) cell count, which restricts the widely application in clinical settings. This study aimed to identify reliable and easy-to-use biomarkers for both diagnosis and prognosis of cirrhotic patients with SBP. Methods We conducted a retrospective study including 413 cirrhotic patients from March 2013 to July 2022 in the First Affiliated Hospital of Guangxi Medical University. Patients’ clinical characteristics and laboratory indices were collected and analyzed. Two machine learning methods (Xgboost and LASSO algorithms) and a logistic regression analysis were adopted to screen and validate the indices associated with the risk of SBP. A predictive model was constructed and validated using the estimated area under curve (AUC). The indices related to the survival of cirrhotic patients were also analyzed. Results A total of 413 cirrhotic patients were enrolled in the study, of whom 329 were decompensated and 84 were compensated. 52 patients complicated and patients with SBP had a poorer Child–Pugh score (P < 0.05). Patients with SBP had a greater proportion of malignancies than those without SBP(P < 0.05). The majority of laboratory test indicators differed significantly between patients with and without SBP (P < 0.05). Albumin, neutrophil-to-lymphocyte ratio (NLR), and ferritin-to-neutrophil ratio (FNR) were found to be independently associated with SBP in decompensated cirrhotic patients using LASSO algorithms, and logistic regression analysis. The model established by the three indices showed a high predictive value with an AUC of 0.808. Furthermore, increased neutrophils, ALP, and C-reactive protein-to-albumin ratio (CAR) were associated with the shorter survival time of patients with decompensated cirrhosis, and the combination of these indices showed a greater predictive value for cirrhotic patients. Conclusions The present study identified FNR as a novel index in the diagnosis of SBP in decompensated patients with cirrhosis. A model based on neutrophils, ALP and CAR showed high performance in predicting the prognosis of patients with decompensated cirrhosis.

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Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes

Jiang

et al. 2023

Preprint

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Background Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis, but the biomarkers for diagnosis have yet to be validated. This study aimed to identify reliable and easy-to-use biomarkers for the diagnosis and prognosis of cirrhotic patients with complicated SBP. Methods Cirrhosis data were collected retrospectively; The clinical features and laboratory test indices were analyzed. The indices related to the SBP of cirrhosis were analyzed. Two machine learning methods (Xgboost and LASSO algorithms) and a logistic regression analysis were adopted to screen and validate the indexed risk associated with SBP risk, then a predictive model was built and validated using the area under curve (AUC) estimated. The indices related to the survival of cirrhotic patients were also analyzed. Results A total of 413 cirrhotic patients were included, of whom 329 were decompensated and 84 were compensated. 52 patients complicated SPB and they were all decompensated patients. Patients with SBP have a poorer Child-Pugh score (P < 0.05) and the proportion of cancers was higher in patients with SBP than in those without SBP (P < 0.05). Most laboratory test indices differed significantly between patients with and without SBP (P < 0.05). Xgboost, LASSO algorithms, and logistic regression analysis identified that albumin, neutrophil-to-lymphocyte ratio (NLR), and ferritin-to-neutrophil ratio (FNR) were independently associated with SBP in uncompensated cirrhotic patients, and that established by the three indices model showed a high predictive value. with the AUC being 0.808. In addition, high neutrophils, ALP and CAR were associated with the shorter survival time of patients with decompensated cirrhosis, and the combination of these indices showed a better prognostic value for cirrhotic patients. Conclusions The present study identified FNR as a new index in the diagnosis of SBP in uncompensated patients with cirrhosis. A model constructed from neutrophils, ALP and CAR showed high performance in predicting the prognosis of patients with uncompensated cirrhosis.

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An exploratory study of ascitic fluid lactate as prognostic factor of mortality in cirrhotic patients with spontaneous bacterial peritonitis

Abstract: Supplemental Digital Content is available in the text.

Cited by 4 publications

References 35 publications

Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis

Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis

Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes

Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes

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