Von Willebrand factor and VITRO score as useful markers predict spontaneous bacterial peritonitis with and without hepatorenal syndrome in Egyptian cirrhotic patients

Abstract

Background Von Willebrand factor (VWF) is commonly elevated in patients with cirrhosis. Moreover, it is a predictor of morbidity and mortality. Aim We aimed to examine whether Egyptian cirrhotic patients have a higher risk of spontaneous bacterial peritonitis and its associated complications based on their von Willebrand factor level. Patients and methods This cross-sectional study included 90 hepatitis c virus (HCV)-positive cirrhotic patients. Group A, consisted of 30 patients without spontaneous bacterial peritonitis; Group B, consisted of 30 patients with spontaneous bacterial peritonitis; and Group C, consisted of 30 patients with spontaneous bacterial peritonitis complicated by hepatorenal syndrome. All study participants had paracentesis samples for diagnostic testing. Serum von Willebrand factor was determined using enzyme-linked immunosorbent assay. Model for end-stage liver disease score, von Willebrand factor antigen/thrombocyte ratio (VITRO) and Child-Pugh stages were calculated. Results Von Willebrand factor level at a cut-off value > 196.5 international unit/deciliter (IU/dL) could predict the presence of spontaneous bacterial peritonitis. Moreover, it has been found that von Willebrand factor cut-off value of >244 IU/dL can predict hepatorenal syndrome. With VITRO score cut-off >2.26, the presence of spontaneous bacterial peritonitis can be predicted. Also, cut-off value>2.60 can be used to predict the occurrence of hepatorenal syndrome as a complication of spontaneous bacterial peritonitis. Conclusion Von Willebrand factor could be a reliable noninvasive predictor of spontaneous bacterial peritonitis and Hepatorenal syndrome in cirrhotic patients.