Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2018
Adjusted Intensive Care Infection Score (ICISΔ)-A new approach for prediction of ascitic fluid infection in patients with cirrhosis.
Сравнительное исследованиеСтатьяВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Wang Han, Yang Ning, Li Yan, Zhang Fangfang, Xie Na, Li Peiran, Sun Zhiqiang, Zhu Jiangong, Mao Yuanli, Li Boan
Аннотация
BACKGROUND: Early and accurate diagnosis is the key to improving survival in cirrhotic patients with ascitic fluid infection.
AIMS: To investigate the usefulness of adjusted Intensive Care Infection Score (ICISΔ) for diagnosis of ascites infection in cirrhotic patients.
METHODS: Cirrhotic patients with ascites (n = 125) were enrolled, and the efficacy of ICIS and ICISΔ for predicting ascites infection was evaluated. ICISΔ was created by using the weighted variation of each ICIS parameter.
RESULTS: The area under the curves (AUCs) of ICIS for the diagnosis of ascites infection were 0.90 (95% CI: 0.84-0.95), 0.85 (95% CI: 0.79-0.90), and 0.87 (95% CI: 0.81-0.93), for SBP, culture-negative SBP, and combined SBP/culture-negative SBP, respectively. ICIS was optimized and diagnostic accuracy was obviously improved. ICISΔ had high AUCs of 0.99 (95% CI: 0.93-1.00) for SBP, 0.98 (95% CI: 0.83-1.00) for culture-negative SBP, and 0.98 (95% CI: 0.94-1.00) for the combination group. The optimal cutoff was identified as ICISΔ > 2, which had >97.8% sensitivity and 100% specificity for diagnosis of both SBP and culture-negative SBP. The ICISΔ had significantly higher AUCs than PCT and CPR in both groups (P = 0.002-0.008). ICISΔ kinetics could differentiate between SBP and culture-negative SBP patients. From sterile ascites, through culture-negative SBP to SBP, three ICISΔ parameters showed an increasing trend.
CONCLUSIONS: ICIS and ICISΔ are simple, rapid, accurate and cost-effective methods for the diagnosis of ascites infection in cirrhotic patients.
AIMS: To investigate the usefulness of adjusted Intensive Care Infection Score (ICISΔ) for diagnosis of ascites infection in cirrhotic patients.
METHODS: Cirrhotic patients with ascites (n = 125) were enrolled, and the efficacy of ICIS and ICISΔ for predicting ascites infection was evaluated. ICISΔ was created by using the weighted variation of each ICIS parameter.
RESULTS: The area under the curves (AUCs) of ICIS for the diagnosis of ascites infection were 0.90 (95% CI: 0.84-0.95), 0.85 (95% CI: 0.79-0.90), and 0.87 (95% CI: 0.81-0.93), for SBP, culture-negative SBP, and combined SBP/culture-negative SBP, respectively. ICIS was optimized and diagnostic accuracy was obviously improved. ICISΔ had high AUCs of 0.99 (95% CI: 0.93-1.00) for SBP, 0.98 (95% CI: 0.83-1.00) for culture-negative SBP, and 0.98 (95% CI: 0.94-1.00) for the combination group. The optimal cutoff was identified as ICISΔ > 2, which had >97.8% sensitivity and 100% specificity for diagnosis of both SBP and culture-negative SBP. The ICISΔ had significantly higher AUCs than PCT and CPR in both groups (P = 0.002-0.008). ICISΔ kinetics could differentiate between SBP and culture-negative SBP patients. From sterile ascites, through culture-negative SBP to SBP, three ICISΔ parameters showed an increasing trend.
CONCLUSIONS: ICIS and ICISΔ are simple, rapid, accurate and cost-effective methods for the diagnosis of ascites infection in cirrhotic patients.