title: High-sensitivity C-reactive protein level is an independent predictor of poor prognosis in cirrhotic patients with spontaneous bacterial peritonitis.
abstract: OBJECTIVE
  The production of high-sensitivity C-reactive protein (hs-CRP) may be affected by hepatic function, and the clinical importance of hs-CRP in patients with liver cirrhosis is still not clear. The aim of this study was to evaluate the clinical implications of hs-CRP in cirrhotic patients with spontaneous bacterial peritonitis (SBP).
  
  
  METHODS
  We retrospectively investigated 336 consecutive patients treated for SBP from 2007 to 2012. The relationship between serum hs-CRP and the result of the treatment was assessed.
  
  
  RESULTS
  A response to antibiotics was observed in 182 patients (54.2%), and 126 patients (37.5%) died of SBP. The initial hs-CRP (odds ratio=1.061, P=0.016), coexistent hepatocellular carcinoma, and Child-Pugh (CP) score were independent prognostic factors for high in-hospital mortality. Serum hs-CRP level was also an independent predictor of lower antibiotic response rate (odds ratio=0.916, P<0.001). However, hs-CRP was negatively correlated with the CP score (r=-0.199, P<0.001) and Model for End-Stage Liver Disease score (r=-0.182, P=0.001).
  
  
  CONCLUSIONS
  This study found that serum hs-CRP level is related to a lower response rate to antibiotics, a higher mortality rate in patients with SBP. The hs-CRP level was negatively correlated with the CP and Model for End-Stage Liver Disease scores, which suggests that the prognostic function of hs-CRP was not a surrogate for hepatic dysfunction.
authors.affiliation: *Department of Internal Medicine †Liver Research Institute, Seoul National University College of Medicine ‡Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Cho
authors.forename: So Youn
authors.initials: SY
authors.lastname: Park
authors.forename: Jeong-Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Lee
authors.forename: Minjong
authors.initials: M
authors.lastname: Lee
authors.forename: Jeong-Ju
authors.initials: JJ
authors.lastname: Yoo
authors.forename: Won-Mook
authors.initials: WM
authors.lastname: Choi
authors.forename: Young Youn
authors.initials: YY
authors.lastname: Cho
authors.forename: Yun Bin
authors.initials: YB
authors.lastname: Lee
authors.forename: Jae Woong
authors.initials: JW
authors.lastname: Yoon
authors.forename: Jung Hee
authors.initials: JH
authors.lastname: Kwon
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Cho
authors.forename: Su Jong
authors.initials: SJ
authors.lastname: Yu
authors.forename: Yoon Jun
authors.initials: YJ
authors.lastname: Kim
authors.forename: Jung-Hwan
authors.initials: JH
authors.lastname: Yoon
authors.forename: Chung Yong
authors.initials: CY
authors.lastname: Kim
authors.forename: Hyo-Suk
authors.initials: HS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein