RESUMO
BACKGROUND: Bacterial infections impair prognosis in patients with cirrhosis. Presepsin and, more recently, resistin are promising markers of infection and sepsis in patients without cirrhosis. AIMS: The aim of our study was to assess the performance of presepsin and resistin as early markers of infection compared with C reactive protein (CRP) and procalcitonin (PCT), and their prognostic relevance in patients with decompensated cirrhosis. METHODS: One hundred and fourteen consecutive patients with decompensated cirrhosis were enrolled and followed-up for 28 days. Diagnostic performances of CRP, PCT, presepsin and resistin were assessed. RESULTS: Fifty-three (46.5%) patients had bacterial infections of which 30 (56%) had sepsis. Presepsin and resistin had similar performance as CRP and PCT for the diagnosis of infection (best cut-off of 1444â¯pg/ml and 20â¯ng/ml, respectively) and sepsis. Presepsin (HRâ¯=â¯5.5; 95%CI: 2.36-13.21, pâ¯<â¯0.0001) and the ≥500â¯pg/ml increase of presepsin at 48â¯h (HRâ¯=â¯9.24; 95%CI: 3.66-23.27, pâ¯<â¯0.008) were independently associated with 28-day mortality. CONCLUSIONS: Presepsin and resistin have similar diagnostic performances to CRP and PCT for bacterial infection in decompensated cirrhosis. Presepsin and Δ presepsin ≥500â¯pg/ml have also a prognostic relevance for 28-day mortality.