Mortality from Spontaneous Bacterial Peritonitis Among Hospitalized Patients in the USA

Niu, Bolin; Kim, Brian; Limketkai, Berkeley N.; Sun, Jing; Li, Zhiping; Woreta, Tinsay A.; Chen, Po Hung

doi:10.1007/s10620-018-4990-y

Cited by 68 publications

(66 citation statements)

References 42 publications

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“…It is not unlikely that the gender effect depends upon type of complication of the liver disease, highlighting the need to assess cause specific death in order to understand the role of gender on prognosis in cirrhosis. Interestingly, mortality in cirrhotic patients with bacterial peritonitis was actually found to be increased in women as compared to men in a recently published study by Niu et al [17].…”

Section: Discussionmentioning

confidence: 94%

Effect of gender on mortality and causes of death in cirrhotic patients with gastroesophageal varices. A retrospective study in Norway

Haukeland¹,

Småstuen²,

Pålsdatter³

et al. 2020

PLoS ONE

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Background & aimsThe prognostic role of gender in patients with liver cirrhosis is not fully understood. Our primary aim was to assess how gender affects cumulative incidence and risk of death without liver transplantation (LT) in cirrhotic patients with gastroesophageal varices. Secondary aims were to assess the relationship between gender and cause specific death, risk of variceal bleeding and incidence rates of gastroesophageal varices in patients with cirrhosis. MethodsAll new patients with gastroesophageal varices due to liver cirrhosis at Oslo University Hospital between 2006 and May 2016 were identified. Clinical data were retrieved retrospectively from hospital files. Causes of death were classified according to a specified protocol in cases of in-hospital-death, otherwise by data from the Norwegian Death Registry. Competing risk analyses were used to calculate cumulative incidences and risks of i) all-cause death, ii) cause-specific death and iii) variceal bleeding or re-bleeding. ResultsCumulative one-and five years incidence of death without LT in 266 included patients were 28% and 51%, respectively. In univariate analysis, risk of death was positively associated with age, Child Pugh class, alcoholic liver disease and presentation with variceal bleeding, and negatively associated with female sex. In a multivariate model, risk of death without LT was associated with female sex ]), age (SHR 1.05 [1.04-1.07] per year), Child Pugh class B (SHR 1.54 [1.03-2.32]) and Child Pugh class C (SHR 4.29 [2.57-7.17]). Variceal bleeding caused 27% of deaths. Adjusting for age and Child Pugh score, a trend towards reduced risk of death due to variceal bleeding was seen in women (SHR 0.53; PLOS ONE PLOS ONE | https://doi.

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Section: Discussionmentioning

confidence: 94%

Effect of gender on mortality and causes of death in cirrhotic patients with gastroesophageal varices. A retrospective study in Norway

Haukeland¹,

Småstuen²,

Pålsdatter³

et al. 2020

PLoS ONE

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“…2 ), there remains a gap between the bench and the beside. Recently, a nationwide review indicated that female gender represents an independent risk factor for mortality in cases of spontaneous bacterial peritonitis [ 137 ]. These findings are in contrast to experimental and clinical results.…”

Section: Discrepancy Of Clinical and Experimental Resultsmentioning

confidence: 99%

Gender differences in trauma, shock and sepsis

Bösch¹,

Angele²,

Chaudry

2018

Military Med Res

111

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Despite efforts in prevention and intensive care, trauma and subsequent sepsis are still associated with a high mortality rate. Traumatic injury remains the main cause of death in people younger than 45 years and is thus a source of immense social and economic burden. In recent years, the knowledge concerning gender medicine has continuously increased. A number of studies have reported gender dimorphism in terms of response to trauma, shock and sepsis. However, the advantageous outcome following trauma-hemorrhage in females is not due only to sex. Rather, it is due to the prevailing hormonal milieu of the victim. In this respect, various experimental and clinical studies have demonstrated beneficial effects of estrogen for the central nervous system, the cardiopulmonary system, the liver, the kidneys, the immune system, and for the overall survival of the host. Nonetheless, there remains a gap between the bench and the bedside. This is most likely because clinical studies have not accounted for the estrus cycle. This review attempts to provide an overview of the current level of knowledge and highlights the most important organ systems responding to trauma, shock and sepsis. There continues to be a need for clinical studies on the prevailing hormonal milieu following trauma, shock and sepsis.

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“…67 In-hospital mortality in patients with SBP is 18 to 38%, with greater rates in patients with advanced age, renal impairment, ICU level care, and advanced liver disease. [68][69][70][71] Furthermore, patients with an MELD (model of end-stage liver disease) score of 22 or higher who are diagnosed with SBP have significantly increased mortality. 72,73 Five days of empiric treatment for SBP with a thirdgeneration cephalosporin is adequate coverage for the main organisms known to cause SBP, E. coli, K. pneumoniae, and S. pneumoniae.…”

Section: Spontaneous Bacterial Peritonitismentioning

confidence: 99%

Infectious Complications in Critically Ill Liver Failure Patients

Cheung

Tanna

Ison

2018

Semin Respir Crit Care Med

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Infections remain a leading cause of morbidity and mortality among patients with liver failure. A number of factors, including relative immune dysfunction and systemic inflammation, bacterial translocation, gut dysbiosis, small intestine bacterial overgrowth, altered bile acid pools, and changes in pH due to acid suppression, contribute to the high rates of infection in this population. Though a range of infections can complicate the course of cirrhotic patients, spontaneous bacterial peritonitis (SBP), cholangitis, and cholecystitis in addition to other infections (i.e. pneumonia, urinary tract infection, bacteremia, and Clostridioides difficile colitis) are more common in this population and will be reviewed in this article. Preventative strategies are directed at minimizing the risk of SBP through the use of targeted antimicrobial prophylaxis. Lastly, the critically ill cirrhotic patient may present with an acute need for liver transplantation. Thus, careful assessment for ongoing infection should be performed and treated to optimize outcomes of transplant, if needed.

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Mortality from Spontaneous Bacterial Peritonitis Among Hospitalized Patients in the USA

Abstract: SBP is associated with significant in-hospital mortality, especially in patients with concurrent risk factors. SBP remains a significant burden to the healthcare system.

Cited by 68 publications

References 42 publications

Effect of gender on mortality and causes of death in cirrhotic patients with gastroesophageal varices. A retrospective study in Norway

Effect of gender on mortality and causes of death in cirrhotic patients with gastroesophageal varices. A retrospective study in Norway

Gender differences in trauma, shock and sepsis

Infectious Complications in Critically Ill Liver Failure Patients

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