Importance of certain pro-inflammatory indices in patients with liver cirrhosis and bacterial infection on prognosis and course of the disease

Med Arh. 2012;66(1):19-23. doi: 10.5455/medarh.2012.66.19.23.

Abstract

Introduction: Certain pro-inflammatory indices serum levels, such as leucocytes count and C-reactive protein appears to be a significant and simple clinical tool in prediction of unfavorable course of liver cirrhosis, its complications due to the bacterial infections, length ofhospitalisation and lethal outcome. Cirrhotic patients often have a complications due to bacterial infection, demanding the unexpected need for hospitalization in 30% to 50% of the cases. THE AIM of this study was to assess the impact of pro-inflammatory indices in patients with liver cirrhosis, in relation to bacterial infection and their evaluation as possible prognostic factors on functional liver deterioration, length of hospitalization and lethal outcome.

Material and methods: The research was conducted as a prospective study, on 120 patients with liver cirrhosis, who were in divided into two groups: I-experimental one of 60 patients with bacterial infection and II-control one of 60 patients, with no infectious complications diagnosed end treated in period 2005.-2010. Year.

Results: Most of the patients of experimental group were in C stage of disease, compared to those in the control one (p < 0.001). They had also, initially significantly higher increased values of pro-inflammatory indices, which were significantly reduced during the treatment (p < 0.001), with average longer length of hospitalisation and lethal outcome (p < 0.001; p < 0.01). CRP and the Le count values were most significant predictive factors for length of hospitalisation and lethal outcome.

Discussion: Pro-inflammatory indices values may predict an unfavorable course and lethal outcome in cirrhotic patients with bacterial infections. Prevention of bacterial infection in those patients improves their long-term survival, achieving the slower course of the underlying disease.

MeSH terms

  • Bacterial Infections / blood*
  • Bacterial Infections / complications
  • Bacterial Infections / diagnosis
  • Biomarkers / blood
  • Blood Sedimentation
  • C-Reactive Protein / analysis*
  • Female
  • Fibrinogen / analysis
  • Humans
  • Inflammation
  • Leukocyte Count
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / mortality
  • Male
  • Middle Aged
  • Prognosis
  • Survival Rate

Substances

  • Biomarkers
  • Fibrinogen
  • C-Reactive Protein