Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study
Abstract Background The neutrophil percentage-to-albumin ratio (NPAR) is a novel measure of systemic inflammation and infection. Low albumin levels increase the risk of infection, while high neutrophil counts indicate the presence of infection. Spontaneous bacterial peritonitis (SBP) is a serious in...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Gut Pathogens |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13099-024-00610-2 |
| _version_ | 1827291497104408576 |
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| author | Nasser Mousa Mohamed salah Sherif Elbaz Alaa Elmetwalli Amr Elhammady Eman Abdelkader Mostafa Abdelsalam Niveen El-wakeel Marwa Mansour Manal Hashem Ola El-Emam Wesam Elderiny Mohammed Abdelaziz Ayman Elgamal Alaa Habib |
| author_facet | Nasser Mousa Mohamed salah Sherif Elbaz Alaa Elmetwalli Amr Elhammady Eman Abdelkader Mostafa Abdelsalam Niveen El-wakeel Marwa Mansour Manal Hashem Ola El-Emam Wesam Elderiny Mohammed Abdelaziz Ayman Elgamal Alaa Habib |
| author_sort | Nasser Mousa |
| collection | DOAJ |
| description | Abstract Background The neutrophil percentage-to-albumin ratio (NPAR) is a novel measure of systemic inflammation and infection. Low albumin levels increase the risk of infection, while high neutrophil counts indicate the presence of infection. Spontaneous bacterial peritonitis (SBP) is a serious infection in cirrhotic ascites, and the potential of NPAR in diagnosing SBP is not yet established. Objective The objective of this study is to determine the diagnostic value of NPAR in identifying SBP. Patients This prospective multicenter study included 465 patients diagnosed with cirrhotic ascites and SBP according to international guidelines. Demographic, clinical, and laboratory data were collected. The sensitivity and specificity of NPAR values for diagnosing SBP were assessed using the receiver operating characteristic curve. Results For SBP diagnosis in the total cohort, NPAR of > 17 had a sensitivity of 85.71%, specificity of 66.67%, and 95% CI (42.1–99.6). In culture-positive SBP, the NPAR at a cut-off > 5.2 had a sensitivity of 85.71%, specificity of 83.33%, and 95% CI (0.709 to 0.979), while in culture-negative SBP, the NPAR at a cut-off > 2.1 had a sensitivity of 92.86%, specificity of 33.33% and CI (0.367 to 0.764). The multivariate analysis revealed that albumin (OR = 2.78, [1.11;3.98], INR (OR = 0.198, [0.066;0.596], creatinine (OR = 0.292, [0.1; 0.81], CRP (OR = 3.18, [1.239;4.52] total leukocytic count (TLC) (OR = 1.97, [1.878; 2.07], platelets (OR = 2.09, [0.99; 2.31] and neutrophil (OR = 3.43, [1.04;3.89] were significantly associated with higher prediction rates for culture positive SBP. Conclusions NPAR could be a new, affordable, noninvasive test for diagnosing SBP. |
| first_indexed | 2024-04-24T12:39:04Z |
| format | Article |
| id | doaj.art-1f29b4078fa04ad68dd98303cefee560 |
| institution | Directory Open Access Journal |
| issn | 1757-4749 |
| language | English |
| last_indexed | 2024-04-24T12:39:04Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Gut Pathogens |
| spelling | doaj.art-1f29b4078fa04ad68dd98303cefee5602024-04-07T11:20:01ZengBMCGut Pathogens1757-47492024-04-011611810.1186/s13099-024-00610-2Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter studyNasser Mousa0Mohamed salah1Sherif Elbaz2Alaa Elmetwalli3Amr Elhammady4Eman Abdelkader5Mostafa Abdelsalam6Niveen El-wakeel7Marwa Mansour8Manal Hashem9Ola El-Emam10Wesam Elderiny11Mohammed Abdelaziz12Ayman Elgamal13Alaa Habib14Tropical Medicine Department, Faculty of Medicine, Mansoura UniversityTropical Medicine Department, Faculty of Medicine, Mansoura UniversityEndemic Diseases and Gastroenterology Department, Aswan UniversityDepartment of Clinical Trial Research Unit and Drug Discovery, Egyptian Liver Research Institute and Hospital (ELRIAH)Internal Medicine Department, Banha UniversityInternal Medicine Department, Mansoura UniversityInternal Medicine Department, Mansoura UniversityMedical Microbiology and Immunology Department, Mansoura UniversityInternal Medicine Department, Mansoura UniversityInternal medicine department, Zagazig UniversityClinical Pathology Department, Mansoura UniversityClinical Pathology Department, Mansoura UniversityTropical Medicine Department, Faculty of Medicine, Mansoura UniversityDepartment of Tropical Medicine, Menoufia UniversityInternal Medicine Department, Mansoura UniversityAbstract Background The neutrophil percentage-to-albumin ratio (NPAR) is a novel measure of systemic inflammation and infection. Low albumin levels increase the risk of infection, while high neutrophil counts indicate the presence of infection. Spontaneous bacterial peritonitis (SBP) is a serious infection in cirrhotic ascites, and the potential of NPAR in diagnosing SBP is not yet established. Objective The objective of this study is to determine the diagnostic value of NPAR in identifying SBP. Patients This prospective multicenter study included 465 patients diagnosed with cirrhotic ascites and SBP according to international guidelines. Demographic, clinical, and laboratory data were collected. The sensitivity and specificity of NPAR values for diagnosing SBP were assessed using the receiver operating characteristic curve. Results For SBP diagnosis in the total cohort, NPAR of > 17 had a sensitivity of 85.71%, specificity of 66.67%, and 95% CI (42.1–99.6). In culture-positive SBP, the NPAR at a cut-off > 5.2 had a sensitivity of 85.71%, specificity of 83.33%, and 95% CI (0.709 to 0.979), while in culture-negative SBP, the NPAR at a cut-off > 2.1 had a sensitivity of 92.86%, specificity of 33.33% and CI (0.367 to 0.764). The multivariate analysis revealed that albumin (OR = 2.78, [1.11;3.98], INR (OR = 0.198, [0.066;0.596], creatinine (OR = 0.292, [0.1; 0.81], CRP (OR = 3.18, [1.239;4.52] total leukocytic count (TLC) (OR = 1.97, [1.878; 2.07], platelets (OR = 2.09, [0.99; 2.31] and neutrophil (OR = 3.43, [1.04;3.89] were significantly associated with higher prediction rates for culture positive SBP. Conclusions NPAR could be a new, affordable, noninvasive test for diagnosing SBP.https://doi.org/10.1186/s13099-024-00610-2The neutrophil percentage-to-albumin ratioLiver cirrhosis and spontaneous bacterial peritonitis |
| spellingShingle | Nasser Mousa Mohamed salah Sherif Elbaz Alaa Elmetwalli Amr Elhammady Eman Abdelkader Mostafa Abdelsalam Niveen El-wakeel Marwa Mansour Manal Hashem Ola El-Emam Wesam Elderiny Mohammed Abdelaziz Ayman Elgamal Alaa Habib Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study Gut Pathogens The neutrophil percentage-to-albumin ratio Liver cirrhosis and spontaneous bacterial peritonitis |
| title | Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study |
| title_full | Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study |
| title_fullStr | Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study |
| title_full_unstemmed | Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study |
| title_short | Neutrophil percentage-to-albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis: a prospective multicenter study |
| title_sort | neutrophil percentage to albumin ratio is a new diagnostic marker for spontaneous bacterial peritonitis a prospective multicenter study |
| topic | The neutrophil percentage-to-albumin ratio Liver cirrhosis and spontaneous bacterial peritonitis |
| url | https://doi.org/10.1186/s13099-024-00610-2 |
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