Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gut Pathogens Pub Date : 2024-04-01 DOI:10.1186/s13099-024-00610-2

Nasser Mousa, Mohamed Salah, Sherif Elbaz, Alaa Elmetwalli, Amr Elhammady, Eman Abdelkader, Mostafa Abdelsalam, Niveen El-Wakeel, Marwa Mansour, Manal Hashem, Ola El-Emam, Wesam Elderiny, Mohammed Abdelaziz, Ayman Elgamal, Alaa Habib

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Abstract

Background: The neutrophil percentage-to-albumin ratio (NPAR) is a novel measure of systemic inflammation and infection. Low albumin levels increase the risk of infection, while high neutrophil counts indicate the presence of infection. Spontaneous bacterial peritonitis (SBP) is a serious infection in cirrhotic ascites, and the potential of NPAR in diagnosing SBP is not yet established.

Objective: The objective of this study is to determine the diagnostic value of NPAR in identifying SBP.

Patients: This prospective multicenter study included 465 patients diagnosed with cirrhotic ascites and SBP according to international guidelines. Demographic, clinical, and laboratory data were collected. The sensitivity and specificity of NPAR values for diagnosing SBP were assessed using the receiver operating characteristic curve.

Results: For SBP diagnosis in the total cohort, NPAR of > 17 had a sensitivity of 85.71%, specificity of 66.67%, and 95% CI (42.1-99.6). In culture-positive SBP, the NPAR at a cut-off > 5.2 had a sensitivity of 85.71%, specificity of 83.33%, and 95% CI (0.709 to 0.979), while in culture-negative SBP, the NPAR at a cut-off > 2.1 had a sensitivity of 92.86%, specificity of 33.33% and CI (0.367 to 0.764). The multivariate analysis revealed that albumin (OR = 2.78, [1.11;3.98], INR (OR = 0.198, [0.066;0.596], creatinine (OR = 0.292, [0.1; 0.81], CRP (OR = 3.18, [1.239;4.52] total leukocytic count (TLC) (OR = 1.97, [1.878; 2.07], platelets (OR = 2.09, [0.99; 2.31] and neutrophil (OR = 3.43, [1.04;3.89] were significantly associated with higher prediction rates for culture positive SBP.

Conclusions: NPAR could be a new, affordable, noninvasive test for diagnosing SBP.

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中性粒细胞百分比与白蛋白比率是自发性细菌性腹膜炎的新诊断指标：一项前瞻性多中心研究。

背景：中性粒细胞百分比与白蛋白比率（NPAR）是衡量全身炎症和感染的一种新方法。白蛋白水平低会增加感染风险，而中性粒细胞计数高则表明存在感染。自发性细菌性腹膜炎（SBP）是肝硬化腹水中的一种严重感染，而 NPAR 在诊断 SBP 方面的潜力尚未确定：本研究旨在确定 NPAR 在鉴别 SBP 方面的诊断价值：这项前瞻性多中心研究纳入了 465 名根据国际指南诊断为肝硬化腹水和 SBP 的患者。研究收集了人口统计学、临床和实验室数据。使用接收器操作特征曲线评估了 NPAR 值诊断 SBP 的灵敏度和特异性：结果：对于所有队列中的 SBP 诊断，NPAR>17 的敏感性为 85.71%，特异性为 66.67%，95% CI 为（42.1-99.6）。在培养阳性 SBP 中，NPAR 临界值 > 5.2 的敏感性为 85.71%，特异性为 83.33%，95% CI 为（0.709-0.979）；而在培养阴性 SBP 中，NPAR 临界值 > 2.1 的敏感性为 92.86%，特异性为 33.33%，CI 为（0.367-0.764）。多变量分析显示，白蛋白（OR = 2.78，[1.11;3.98]）、INR（OR = 0.198，[0.066;0.596]）、肌酐（OR = 0.292，[0.1;0.81]）、CRP（OR = 3.18，[1.239;4.52]）、白细胞总数（TLC）（OR = 1.97，[1.878; 2.07]）、血小板（OR = 2.09，[0.99; 2.31]）和中性粒细胞（OR = 3.43，[1.04; 3.89]与培养阳性 SBP 的预测率显著相关：NPAR可作为诊断SBP的一种新型、经济、无创的检测方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gut Pathogens GASTROENTEROLOGY & HEPATOLOGY-MICROBIOLOGY

CiteScore

7.70

自引率

2.40%

发文量

期刊介绍： Gut Pathogens is a fast publishing, inclusive and prominent international journal which recognizes the need for a publishing platform uniquely tailored to reflect the full breadth of research in the biology and medicine of pathogens, commensals and functional microbiota of the gut. The journal publishes basic, clinical and cutting-edge research on all aspects of the above mentioned organisms including probiotic bacteria and yeasts and their products. The scope also covers the related ecology, molecular genetics, physiology and epidemiology of these microbes. The journal actively invites timely reports on the novel aspects of genomics, metagenomics, microbiota profiling and systems biology. Gut Pathogens will also consider, at the discretion of the editors, descriptive studies identifying a new genome sequence of a gut microbe or a series of related microbes (such as those obtained from new hosts, niches, settings, outbreaks and epidemics) and those obtained from single or multiple hosts at one or different time points (chronological evolution).