Clinical, Biochemical and Inflammatory Predictors of Mortality in Patients with Spontaneous Bacterial Peritonitis | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 37, Volume 86, Issue 1, January 2022, Pages 228-237 PDF (1.37 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2022.211058 | ||
| Authors | ||
| Talaat Zakareya* ; Wael Mohamed Abd El-Razek; Mohamed Akl Rady; Heba Mohamed Abdallah; Ahmed Ali El-Awady; Mohamed Ali Abbasy | ||
| Department of Gastroenterology and Hepatology, National Liver Institute, Menoufiya University, Shebeen El-Kom, Menoufiya, 32511, Egypt, | ||
| Abstract | ||
| Background: Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis. It contributes to high morbidity and mortality in this population. In-hospital mortality of SBP ranges between 20% and 40%, suggesting that further refinements are essential in managing SBP. Early recognition of high-risk patients would enable us to reduce the short-term mortality. Objective: The current study aimed to evaluate the value of clinical, biochemical and inflammatory markers in the prediction of 1-month and 3-month cumulative mortality in patients with SBP. Patients and methods: Two hundred patients with a confirmed diagnosis of SBP were enrolled. They were admitted and received the proper treatment at the National Liver Institute Hospital-Menoufia University, Egypt. Patients were prospectively followed up for mortality over a period of three months. Predictors of mortality were assessed and analyzed. Results: Mortality rates were 20% and 41% at 1 month and 3 month respectively. Our findings showed that low blood pressure, abdominal pain, fever, higher Child-Pugh score, MELD score, serum bilirubin, INR, serum creatinine, C-reactive protein to albumin (CRP/Albumin) ratio, neutrophil–lymphocyte ratio (NLR), massive splenomegaly and large ascites have been demonstrated as risk factors associated with short-term mortality. Conclusion: SBP carries a high risk of mortality among cirrhotic patients. Clinical parameters (low blood pressure, abdominal pain, fever, massive splenomegaly and large ascites), prognostic scores (Child-Pugh and MELD) and inflammatory markers (CRP, CRP/albumin ratio, and NLR) seem to be accurate and reliable tools that could independently predict short-term mortality in patients with SBP. | ||
| Keywords | ||
| Spontaneous bacterial peritonitis; SBP mortality predictors; C-reactive protein; CRP-albumin ratio; Neutrophil–lymphocyte ratio | ||
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