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Volume 39 Issue 8
Aug.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(8): 1880-1885

Clinical value of C-reactive protein/albumin ratio in the diagnosis of alcoholic cirrhosis with spontaneous bacterial peritonitis

DOI: 10.3969/j.issn.1001-5256.2023.08.017
  • 1.

    Department of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

  • 2.

    Graduate School, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China

Research funding:

Capital Health Research and Development Project (2020-2-2172);

The State Administration of Traditional Chinese Medicine Key Specialty of Liver Disease 

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  • Corresponding author: JIANG Yuyong, jyuy11@126.com (ORCID: 0000-0002-6082-1180)
  • Received Date: 2022-10-25
  • Accepted Date: 2022-12-05
  • Published Date: 2023-08-20
    Abstract
  •   Objective  To investigate the clinical value of C-reactive protein/albumin ratio (CAR) in determining spontaneous bacterial peritonitis (SBP) in patients with alcoholic cirrhosis (ALC).  Methods  A retrospective analysis was performed for 329 ALC patients with SBP who were hospitalized in Beijing Ditan Hospital, Capital Medical University, from August 2020 to February 2022, and according to the presence or absence of SBP on admission, they were divided into non-SBP group with 246 patients and SBP group with 83 patients. The two groups were compared in terms of sex, age, comorbidities, complications, blood routine, liver and renal function, blood lipids, and coagulation markers. The independent-samples t test was used for comparison of normally distributed quantitative data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed quantitative data between two groups; the chi-square test was used for comparison of qualitative data between two groups. A multivariate binary logistic regression analysis was used to identify the risk factors for SBP. The receiver operating characteristic (ROC) curve was plotted for CAR to calculate the area under the ROC curve (AUC), the optimal cut-off value, and 95% confidence interval (CI).  Results  Compared with the non-SBP patients, the SBP patients had significantly higher inflammatory indicators (WBC, neutrophils, NLR, monocytes, C-reactive protein, and CAR), significantly higher aspartate aminotransferase, total bilirubin, international normalized ratio, and MELD score, and significantly lower levels of albumin and high-density lipoprotein (all P < 0.05). The multivariate logistic regression analysis showed that CAR (odds ratio [OR]=20.628, 95%CI: 6.720-74.052, P < 0.01) and red blood cell count (OR=0.600, 95%CI: 0.381-0.932, P=0.025) were independent risk factors for determining SBP in ALC patients. CAR had a significantly larger AUC than NLR and WBC (0.825 vs 0.725/0.651) and an optimal cut-off value of 0.324. The patients were divided into high-risk group and low-risk group, and the analysis showed that the high-risk group had a significantly higher proportion of patients with SBP than the low-risk group [63.2% (55/87) vs 11.6%(28/242), χ2=90.495, P < 0.01].  Conclusion  CAR is a good marker for determining SBP in patients with ALC.

     

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