Prognostic factors associated with in-hospital mortality in patients with spontaneous bacterial peritonitis

Musskopf, Maiara Isabel; Fonseca, Fabricio Pimentel; Gass, Jeferson; Mattos, Ângelo Zambam de; John, Jorge Alberto; Brandão, Ajácio Bandeira de Mello

doi:10.1016/s1665-2681(19)31418-8

Cited by 21 publications

(5 citation statements)

References 24 publications

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“…Furthermore, the same study showed that each hour of delay in performing paracentesis from hospitalisation is associated with a 3.3% increase in mortality after adjusting for MELD and creatinine levels [18]. Serum creatinine was an independent predictor of both mortality at 32 months and inpatient mortality in our study, and this has been consistently corroborated by other studies [26,28–31]. However, our 46% prevalence of HRS-AKI is higher than that reported by Terg et al [30].…”

Section: Discussionsupporting

confidence: 90%

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Outcomes after hospitalisation with spontaneous bacterial peritonitis over a 13-year period: a retrospective cohort study

Ubhi

Mourad

Tausan

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Goals Assess outcomes in patients with an index presentation of spontaneous bacterial peritonitis (SBP) over a 13-year period. Background SBP, a bacterial infection of ascites, has a poor prognosis. Study Retrospective cohort study assessing mortality (standardised to 32 months) and prognostic factors in patients with SBP during two periods: period 1 (June 2006–November 2012) and period 2 (December 2012–May 2019). Results The study included 178 patients who were followed up for 11.6 (29.2) months. Mortality was high, with 12-, 24- and 32-month survival being 32%, 26% and 24%, respectively. Inpatient mortality was 36% with mortality in those surviving hospitalisation being 62%. Serum creatinine at the time of SBP diagnosis was an independent predictor of mortality at 32 months [hazard ratio (HR) 1.002, P = 0.023] and inpatient mortality (HR 1.003, P = 0.035). Positive ascitic fluid culture and ascitic fluid neutrophil count were independent predictors of 32-month (HR 1.679, P = 0.008) and inpatient mortality (HR 1.0001, P = 0.005), respectively. Patients in period 2 had lower ascitic fluid albumin (5.9 ± 3.3 g/L vs. 10.8 ± 5.4 g/L, P < 0.001), higher ascitic fluid neutrophil count (815.0 cells/mm3 vs. 345.0 cells/mm3, P < 0.001) and higher rates of hepatorenal syndrome-acute kidney injury (58 vs. 35%, P = 0.002). Mortality at 32 months and mortality in those surviving hospitalisation were similar at 78 vs. 73%, P = 0.392 and 66 vs. 58%, P = 0.355, for periods 1 and 2, respectively. Conclusions Despite more advanced initial presentations, mortality rates have remained similar over the last 13 years. Serum creatinine at the time of SBP diagnosis is an independent predictor of mortality.

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Section: Discussionsupporting

confidence: 90%

“…Our data highlights the ongoing poor survival in those admitted to hospitals with SBP, our inpatient mortality of 36% is consistent with earlier studies (20–40%) [25,26]. The prompt diagnosis and treatment of SBP are essential in improving outcomes [27].…”

Section: Discussionsupporting

confidence: 90%

Outcomes after hospitalisation with spontaneous bacterial peritonitis over a 13-year period: a retrospective cohort study

Ubhi

Mourad

Tausan

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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“…Karvellas et al [ 11 ] analyzed aspects of antimicrobial therapy to mortality in patients with SBP from an international multicenter database over a 15-year time span, yielding a cohort of 126 patients. In three studies assessing factors associated with recurrence of SBP, 139 patients over a 4-year period, 124 patients over a 3-year period, and 111 patients in a 1-year analysis have contributed to practice changing results [ 22 , 24 , 27 ]. In addition, other studies of patients with SBP have shown in-hospital mortality rates of 37–81%, which encompass similar results to our cohort, allowing generalizability to other populations with SBP [ 10 , 11 , 13 , 27 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…In three studies assessing factors associated with recurrence of SBP, 139 patients over a 4-year period, 124 patients over a 3-year period, and 111 patients in a 1-year analysis have contributed to practice changing results [ 22 , 24 , 27 ]. In addition, other studies of patients with SBP have shown in-hospital mortality rates of 37–81%, which encompass similar results to our cohort, allowing generalizability to other populations with SBP [ 10 , 11 , 13 , 27 – 29 ]. However, approximately 40% of our population had active malignancy, which is considerably higher than other studies that range from 7.2 to 18% [ 10 , 13 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Delayed Paracentesis in Patients with Spontaneous Bacterial Peritonitis

et al. 2020

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Background and Aim In patients with spontaneous bacterial peritonitis (SBP), studies show that delayed paracentesis (DP) is associated with worse outcomes and mortality. We aimed to assess the rate of DP in the community setting and associated factors with early versus delayed paracentesis. Methods Patients hospitalized with SBP were retrospectively studied between 12/2013 and 12/2018. DP was defined as paracentesis performed > 12 h from initial encounter. Data collected included: patient factors (i.e., age, race, symptoms, history of SBP, MELD) and physician factors (i.e., admission service, shift times, providers ordering and performing paracentesis). Logistic regression analysis was performed to assess for factors associated with DP. Results DP occurred 82% of the time ( n = 97). The most significant factors in predicting timing of paracentesis were ordering physician [emergency department (ED) physician was associated with early paracentesis (57% vs 8%, p < 0.001) and specialty of physician performing paracentesis (interventional radiology was associated with DP (88% vs 48%, p < 0.001)]. Younger patients were more likely to receive early paracentesis. In regression analysis, the factor most associated with early paracentesis was when the order was made by the ED provider (OR 0.07, 95% CI 0.02–0.22). No differences were observed in patients with prior history of SBP, abdominal pain, encephalopathy, or creatinine level. Conclusions Studies have suggested that DP is associated with increased mortality in patients with SBP. Despite this, DP is common in the community setting and is influenced by ordering physician and specialty of physician performing paracentesis. Future efforts should assess interventions to improve this important quality indicator.

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“…4 Previous reports on the prognosis for SBP have been focused on risk factors or prediction models for short-term or inpatient outcomes. [5][6][7][8][9][10][11] Detection of death within 1 year could aid in delivering proper care and optimizing use of limited resources for treatment. In this study, we aimed to identify independent predictors of 1-year survival in patients after the first episode of SBP in cirrhosis, in order to construct and validate a risk prediction score to assess individual prognosis.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Prognostic Model for One-year Survival of Cirrhosis Patients with First-ever Spontaneous Bacterial Peritonitis

Wang¹,

Gu²,

Wei³

et al. 2021

Journal of Clinical and Translational Hepatology

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Background and Aims: Spontaneous bacterial peritonitis (SBP) is one of the leading causes of death in patients with liver cirrhosis. We aimed to establish a prognostic model to evaluate the 1-year survival of cirrhosis patients after the first episode of SBP. Methods: A prognostic model was developed based on a retrospective derivation cohort of 309 cirrhosis patients with first-ever SBP and was validated in a separate validation cohort of 141 patients. We used Uno's concordance, calibration curve, and decision curve (DCA) analysis to evaluate the discrimination, calibration, and clinical net benefit of the model. Results: A total of 59 (19.1%) patients in the derivation cohort and 42 (29.8%) patients in the validation cohort died over the course of 1 year. A prognostic model in nomogram form was developed with predictors including age [

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Prognostic factors associated with in-hospital mortality in patients with spontaneous bacterial peritonitis

Cited by 21 publications

References 24 publications

Outcomes after hospitalisation with spontaneous bacterial peritonitis over a 13-year period: a retrospective cohort study

Outcomes after hospitalisation with spontaneous bacterial peritonitis over a 13-year period: a retrospective cohort study

Factors Associated with Delayed Paracentesis in Patients with Spontaneous Bacterial Peritonitis

Development and Validation of a Prognostic Model for One-year Survival of Cirrhosis Patients with First-ever Spontaneous Bacterial Peritonitis

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