Adjusted Intensive Care Infection Score (ICISΔ)-A new approach for prediction of ascitic fluid infection in patients with cirrhosis.

Abstract

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.

• Authors: Han Wang, Ning Yang, Yan Li, Fangfang Zhang, Na Xie, Peiran Li, Zhiqiang Sun, Jiangong Zhu, Yuanli Mao, Boan Li
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 51 Issue 1 Pg. 104-111 (01 2019) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 30042037 (Publication Type: Comparative Study, Journal Article, Validation Study)
• Copyright: Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Topics

• Adult
• Ascites (blood, diagnosis, microbiology)
• Ascitic Fluid (microbiology)
• Female
• Humans
• Intensive Care Units
• Liver Cirrhosis (complications)
• Male
• Middle Aged
• Peritonitis (blood, diagnosis, etiology, microbiology)
• Predictive Value of Tests
• Prospective Studies
• ROC Curve
• Statistics, Nonparametric