Evaluation of A Novel Index That Incorporates Both Neutrophil-Lymphocyte Ratio and C-Reactive Protein for The Detection of Spontaneous Bacterial Peritonitis | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 141, Volume 94, Issue 1, January 2024, Pages 950-956 PDF (627.35 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2024.344774 | ||
| Abstract | ||
| Background: Diagnosing spontaneous bacterial peritonitis (SBP) requires a high clinical index of suspicion because the clinical presentation varies widely. Early detection and treatment of SBP are crucial for improving survival rates. Minimally invasive markers such as blood neutrophil-lymphocyte ratio (NLR) and serum C-reactive protein (CRP) could be helpful to clinicians in identifying SBP patients. Objective: This study aimed to assess the diagnostic efficacy of integrating measurements of NLR and CRP as a minimally invasive approach for detecting SBP. Patients and methods: This was a cross-sectional study that included 124 cirrhosis-related ascites patients admitted to the Alexandria Main University Hospital in the Department of Internal Medicine. Participants with ≥ 250 neutrophil cells/mm3 in ascitic fluid were defined as the SBP group (50 patients). In contrast, those with less than 250 neutrophil cells/mm3 in ascitic fluid and negative ascitic cultures were the non-SBP group (74 participants). Results: There was a substantially elevated blood NLR and CRP in SBP patients (p < /em><0.001). Analyzed separately, NLR exceeding 3.16 offered a sensitivity of 76% and specificity of 97.3%, whereas CRP above 45.6 mg/L yielded a sensitivity of 84% and specificity of 91.8%. Our new index “NLR x √CRP” at a cutoff > 18.28significantly improved diagnostic precision, with a better sensitivity of 94.0% and specificity of 94.59%. Conclusions: The use of “NLR x √CRP index” at a cutoff > 18.28 introduces an innovative, efficient, economical, and minimally invasive strategy for the diagnosis of SBP. | ||
| Keywords | ||
| Spontaneous bacterial peritonitis; Inflammatory markers; C-Reactive protein; Neutrophil-Lymphocyte ratio | ||
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