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001-es BibID:	BIBFORM065752
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Presepsin teardown : pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis / Maria Papp, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Tamas Dinya, Andrea Sumegi, Peter Antal-Szalmas
Dátum:	2016
Megjegyzések:	AIM: Bacterial infections are frequent complications in cirrhosis with significant mortality. Early laboratory diagnosis is essential but challenging. We aimed to evaluate the diagnostic and prognostic value of presepsin in cirrhosis associated bacterial infections. METHODS: 216 patients with cirrhosis were enrolled. At admission, presence of bacterial infections and level of plasma presepsin, serum CRP and PCT were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality. RESULTS: 34.7% of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 vs. 477 pg/mL, p<0.001), increasing with the severity of infection (organ failure[OF]Yes vs. No: 2358 vs. 710 pg/mL, p<0.001). Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, p=NS for presepsin vs. PCT and p<0.01 for presepsin vs. CRP). At the optimal cut-off value of presepsin>1206 pg/mL sensitivity, specificity, PPV and NPV were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-day mortality rate was higher among patients with >1277 pg/mL compared to those with ?1277 pg/mL (46.9% vs. 11.6%, p<0.001). In a binary logistic regression analysis, however, only PCT [OR: 1.81, (95%CI: 1.09?3.01), p=0.022] but neither presepsin and nor CRP were independent risk factor for 28-day mortality after adjusting with MELD score and leukocyte count.CONCLUSION: Presepsin is a valuable new biomarker for defining severe infections in cirrhosis proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban presepsin cirrhosis bacterial infection organ failure mortality
Megjelenés:	World Journal of Gastroenterology 22 : 41 (2016), p. 1-14. -
További szerzők:	Tornai Tamás István (1984-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Sümegi Andrea (1969-) (biológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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