Procalcitonin in Cirrhotic Patients at High Risk for Sepsis

Role of Procalcitonin (PCT) for the Diagnosis of Sepsis in Ascitic Cirrhotic Patients

Infections are frequent life-threatening events in patients with cirrhosis, occurring at least in 35% of hospitalized patients and accounting for 20% of inpatients death. Among cirrhotics, ascitic patients have the highest risk of death for sepsis. At the admission, no clear-cut clinical and biochemical features are helpful in diagnosing and prognostically stratifying those patients with sepsis. Procalcitonin (PCT)is a breakthrough marker presenting high sensibility and specificity in diagnosing bacterial infections in different clinical settings. The purpose of this study is to evaluate PCT as a diagnostic and prognostic tool for sepsis in hospitalized cirrhotic patients with ascitic decompensation.

Inclusion Criteria:

• liver cirrhosis regardless of aetiology
• clinically relevant ascitic decompensation at time of hospital admission

Exclusion Criteria:

• high haematic ascites
• ongoing antimicrobial therapy or stopped less than 7 days before admission
• last hospital discharge within 7 days
• surgery or trauma within 30 days from enrolment
• hepatocellular carcinoma out of Milan criteria
• extra hepatic malignancies
• immunodeficiency syndrome
• pregnancy