Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites

Background Patients with ascites are at risk for developing spontaneous bacterial peritonitis (SBP) – a severe complication associated with high mortality. We aimed to identify risk factors for SBP development and mortality to optimize stratification for primary prophylaxis and therapeutic strategie...

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Bibliographic Details
Published in:Liver international 2015-09, Vol.35 (9), p.2121-2128
Main Authors: Schwabl, Philipp, Bucsics, Theresa, Soucek, Kathrin, Mandorfer, Mattias, Bota, Simona, Blacky, Alexander, Hirschl, Alexander M., Ferlitsch, Arnulf, Trauner, Michael, Peck-Radosavljevic, Markus, Reiberger, Thomas
Format: Article
Language:English
Subjects:
Aged
ascites
Ascites - complications
Ascites - etiology
Ascitic Fluid - microbiology
Austria
Bacterial Infections - complications
cirrhosis
development
Female
Humans
Kaplan-Meier Estimate
Liver Cirrhosis - complications
Logistic Models
Male
Middle Aged
mortality
Multivariate Analysis
Paracentesis
Peritonitis - diagnosis
Peritonitis - microbiology
Peritonitis - mortality
Retrospective Studies
Risk Factors
Sodium - blood
spontaneous bacterial peritonitis
Tertiary Care Centers
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Summary:Background Patients with ascites are at risk for developing spontaneous bacterial peritonitis (SBP) – a severe complication associated with high mortality. We aimed to identify risk factors for SBP development and mortality to optimize stratification for primary prophylaxis and therapeutic strategies to improve survival. Methods 575 patients with cirrhosis and ascites undergoing paracentesis at a tertiary care hospital were included in this retrospective cohort study. Demographical, clinical and laboratory parameters were recorded at first paracentesis and during follow‐up. Multivariate logistic regression analysis was used to identify independent predictors of SBP development and mortality. Results Child–Pugh stage C (OR: 3.323; P = 0.009), ascitic fluid polymorph‐nuclear cell (PMN) count (OR: 1.544; P = 0.028) and low serum sodium (OR: 0.917; P = 0.029) emerged as independent risk factors for SBP development. SBP‐naïve patients undergoing paracentesis and presenting with PMN‐counts ≥100 cells/μl, or hyponatraemia
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.12795