Predictors of spontaneous bacterial peritonitis in Romanian adults with liver cirrhosis: Focus on the neutrophil‑to‑lymphocyte ratio

Popoiag,Roxana-Emanuela; Suceveanu,Andra-Iulia; Suceveanu,Adrian-Paul; Micu,Sergiu Ioan; Voinea,Felix; Mazilu,Laura; Petcu,Lucian Cristian; Panaitescu,Eugenia; Cozaru,Georgeta; Fierbințeanu‑Braticevici,Carmen

doi:10.3892/etm.2021.10415

September-2021 Volume 22 Issue 3

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September-2021 Volume 22 Issue 3

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Article

Predictors of spontaneous bacterial peritonitis in Romanian adults with liver cirrhosis: Focus on the neutrophil‑to‑lymphocyte ratio

Authors:
- Roxana-Emanuela Popoiag
- Andra-Iulia Suceveanu
- Adrian-Paul Suceveanu
- Sergiu Ioan Micu
- Felix Voinea
- Laura Mazilu
- Lucian Cristian Petcu
- Eugenia Panaitescu
- Georgeta Cozaru
- Carmen Fierbințeanu‑Braticevici
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Affiliations: Department of Internal Medicine, Faculty of Medicine, ‘Ovidius’ University, 900527 Constanta, Romania, Department of Gastroenterology, Emergency Clinical Hospital ‘St. Apostle Andrew’, 900591 Constanta, Romania, Department of Urology, Emergency Clinical Hospital ‘St. Apostle Andrew’, 900591 Constanta, Romania, Department of Oncology, Emergency Clinical Hospital ‘St. Apostle Andrew’, 900591 Constanta, Romania, Department of Biophysics and Biostatistics, Dentistry Faculty, ‘Ovidius’ University, 900527 Constanta, Romania, Department of Informatics and Biostatistics, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Pathology Department, Emergency Clinical Hospital ‘St. Apostle Andrew’, 900591 Constanta, Romania, Department of Gastroenterology, University Emergency Hospital, 050098 Bucharest, Romania
Article Number: 983
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Published online on: July 12, 2021

https://doi.org/10.3892/etm.2021.10415
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Abstract

Spontaneous bacterial peritonitis (SBP) is a severe complication of liver cirrhosis whose diagnosis is based on a polymorphonuclear leukocyte (PMN) value >250 mm3, yet this PMN value cannot identify all existing types. The aim of our study was to determine the clinical and biological factors that were associated with SBP and predict its occurrence, focusing on the neutrophil‑to‑lymphocyte ratio (NLR) as one of them. Our retrospective study included 216 patients with liver cirrhosis who were hospitalized between December 2019 and January 2010 at the Emergency County Clinical Hospital of ‘St. Apostle Andrew’ in Constanta, Romania. Demographic, clinical, and laboratory data were collected from patient observation sheets. The patients were divided into two groups: One group of patients with SBP and the other without SBP. The diagnosis of SBP was made when patients presented with PMN >250 mm³ and other causes of secondary bacterial peritonitis were excluded. The mean age of the patients was 61.25±10.67 years, and the alcoholic etiology of liver cirrhosis was most common (44%). Univariate logistic regression analysis showed that there was an association between biological parameters, such as serum white blood cells, total platelet count, total bilirubin, serum albumin, international normalized ratio, creatinine, erythrocyte sedimentation rate (ESR), serum sodium, alkaline reserve, and NLR, and clinical parameters, such us upper gastrointestinal bleeding and cardiac comorbidities in the occurrence of SBP. Multivariate analysis identified ESR and NLR as predictive factors in the occurrence of SBP. The area under the curve (AUC) was 0.916 [P<0.001, 95% confidence interval (CI) 0.870‑0.949] for ESR and AUC was 0.963 (P<0.001, 95% CI 0.928‑0.984) for NLR, respectively. In conclusion, the combination of these 2 biological parameters is useful in identifying or excluding SBP.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Predictors of spontaneous bacterial peritonitis in Romanian adults with liver cirrhosis: Focus on the neutrophil‑to‑lymphocyte ratio

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