{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:30Z","timestamp":1787014110543,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spontaneous bacterial peritonitis (SBP) is a frequent and life\u2010threatening complication of cirrhosis, contributing to considerable morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional derivation study was conducted to assess the diagnostic accuracy of two sepsis\u2010related calcitonin peptide family biomarkers, mid\u2010regional pro\u2010adrenomedullin (MR\u2010pro\u2010ADM) and procalcitonin, in ascitic fluid for identifying bacteriologically confirmed SBP (BC\u2010SBP). In a subsequent validation study, the diagnostic performance of the \u2018SBP score\u2019 was evaluated in an independent patient cohort using an absolute polymorphonuclear (PMN) leukocyte count threshold of \u2265250 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      as the diagnostic benchmark for diagnosing SBP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the derivation study, the concentration of MR\u2010pro\u2010ADM in ascitic fluid was significantly higher in patients with BC\u2010SBP compared to those without BC\u2010SBP (3.14\u2009nmol\/L [IQR, 2.39\u20136.74] vs. 1.91\u2009nmol\/L [IQR, 1.33\u20132.80];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.0002). Bayesian ANOVA indicated that MR\u2010pro\u2010ADM was highly discriminative for diagnosing BC\u2010SBP, with a substantial Bayes factor (BFM\u2009=\u20092505), whereas procalcitonin exhibited poor discriminatory performance. Receiver\u2010operating characteristic (ROC) analysis identified an optimal MR\u2010pro\u2010ADM cut\u2010off of \u22652.50\u2009nmol\/L for diagnosing BC\u2010SBP, with an area under the ROC curve (AUROC) of 0.746 (95% CI, 0.685\u20130.801;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Multivariable logistic regression identified three independent predictors of BC\u2010SBP, which were subsequently incorporated into the \u2018SBP score\u2019 (MR\u2010pro\u2010ADM \u22652.5\u2009nmol\/L, absolute PMN count \u2265250 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      and Child\u2013Pugh score). In the validation study, the \u2018SBP score\u2019 demonstrated an AUROC of 0.993 (95% CI, 0.929\u20131.000;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001) for diagnosing SBP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MR\u2010pro\u2010ADM in ascitic fluid emerges as a promising biomarker for SBP diagnosis. Combining MR\u2010pro\u2010ADM with absolute PMN count and Child\u2013Pugh score in the \u2018SBP score\u2019 greatly improves the diagnostic accuracy of SBP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.70021","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T01:46:04Z","timestamp":1741743964000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mid\u2010regional pro\u2010adrenomedullin: A rapid sepsis biomarker for diagnosing spontaneous bacterial peritonitis in cirrhosis"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9731-4529","authenticated-orcid":false,"given":"Abderrahim","family":"Oussalah","sequence":"first","affiliation":[{"name":"Department of Genomic Medicine, Division of Biochemistry, Molecular Biology and Nutrition University Hospital of Nancy  Nancy France"},{"name":"University of Lorraine INSERM UMR_S 1256, 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