Abstract: Objective The aim of this study was to explore the value of serum pro-adrenomedullin (pro-ADM) levels in the diagnosis of bacterial infection and the prediction of short-term prognosis in patients with decompensated cirrhosis(DC). Methods 229 patients with DC were prospectively enrolled between January 2016 and December 2017 in Hwamei Hospital, University of Chinese Academy of Sciences. Serum pro-ADM levels were detected, ,and the value of serum pro-ADM in the diagnosis of infection and the prediction of 28-day mortality in patients with DC was analyzed. Results Out of the 229 DC patients, the bacterial infections occurred in 60 cases (26.2%), with the 28-day mortality of 6.1% and 90-day mortality of 12.2%; serum pro-ADM level in patients with bacterial infection was 13.0(12.3, 13.7) nmol/L, significantly higher than (8.8(7.5, 11.0)nmol/L, P<0.001) in patients without; the multivariate Logistic regression analysis showed that serum pro-ADM, peripheral white blood cell(WBC) counts, C-reactive protein (CRP) and MELD score were the independent risk factors for bacterial infection (P<0.05), and serum pro-ADM, WBC counts and MELD score were the independent risk factors for 28-day mortality (P<0.05); the AUC of serum pro-ADM level in predicting bacterial infection in patients with DC was 0.674(95% CI:0.609-0.734), and the AUC of combination of it with WBC counts and CRP was 0.787(95% CI:0.729-0.839). Conclusions The detection of serum pro-ADM levels might help diagnose the bacterial infection in patients with DC, and those with extremely increased serum pro-ADM levels hints poor prognosis.

Key words: Liver cirrhosis, Pro-adrenomedullin, Bacterial infection, Short-term survival