Lubis F.1, Okvaria R.2, Ifnati R.3, Habib M.4
1Sumpal Clinic, Sekayu, Indonesia, 2Charitas Hospital, Palembang, Indonesia, 3Rawa Clinic, Sekayu, Indonesia, 4Mahyuzahra Hospital, Indralaya, Indonesia
Background/Aims: Spontaneous bacterial peritonitis (SBP) is life-threatening condition in patient with cirrhosis and remains a diagnostic challenge for clinicians. Many studies have explored the potential role of procalcitonin (PCT) & C-reactive protein (CRP) for detecting SBP in cirrhosis. However, the overall diagnostic value remains unclear. Therefore, we performed a meta-analysis to assess the diagnostic accuracy of PCT & CRP for SBP in patients with cirrhosis.
Methods: A literature search was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and corresponding 95% credible interval (95% CI) were calculated using a bivariate regression model. he pooled sensitivity, specificity, PLR, NLR, DOR, AUC, and corresponding 95% CI were the primary outcomes.
Results: There are 387 studies searched from PubMed, Cochrane, and Google Scholar databases. Included in the analyses were 18 studies with 2028 patients in this meta-analysis. The summary estimates using PCT and CRP for detecting SBP in patient with cirrhosis were as follows: sensitivity 91% (95% CI: 86%-95%) versus 83% (95% CI: 78%-87%); specificity 82% (95% CI: 73%-89%) versus 78% (95% CI: 65%-87%). Furthermore, the pooled DOR, PLR, NLR of PCT were 49.82 (95% CI: 18.72
Conclusion: Our results indicate the significance value of PCT and CRP for the diagnosis of SBP in cirrhosis. The diagnosis accuracy of PCT is higher than those of CRP.
Keywords: Procalcitonin, C-Reactive Protein, Diagnosis, Cirrhosis, Bacterial peritonitis