Prognostic factors of liver cirrhosis mortality after a first episode of spontaneous bacterial peritonitis. A multicenter study.
Rev Esp Enferm Dig
; 110(2): 94-101, 2018 Feb.
Article
in En
| MEDLINE
| ID: mdl-29313695
ABSTRACT
INTRODUCTION:
Spontaneous bacterial peritonitis is an infectious complication with a negative impact on survival of patients with cirrhosis.OBJECTIVE:
To analyze the short- and long-term survival after a first episode of bacterial peritonitis and the associated prognostic factors. PATIENTS ANDMETHODS:
This was a retrospective, multicenter study of patients admitted to hospital for spontaneous bacterial peritonitis between 2008 and 2013. Independent variables related to mortality were analyzed by logistic regression. The prognostic power of the Child Pugh Score, the Model for End-Stage Liver Disease (MELD) and the Charlson index was analyzed by ROC curve.RESULTS:
A total of 159 patients were enrolled, 72% were males with a mean age of 63.5 years and a mean MELD score of 19 (SD ± 9.5). Mortality at 30 and 90 days and one and two years was 21%, 31%, 55% and 69%, respectively. Hepatic encephalopathy (p = 0.008, OR 3.5, 95% CI 1.4-8.8) and kidney function (p = 0.026, OR 2.7, 95% CI 1.13-16.7) were independent factors for short- and long-term mortality. MELD was a good marker of short- and long-term survival (area under the curve [AUC] 0.7 95% CI 1.02-1.4). The Charlson index was related to long-term mortality (AUC 0.68 95% CI 0.6-0.77).CONCLUSIONS:
Short- and long-term mortality of spontaneous bacterial peritonitis is still high. The main prognostic factors for mortality are impairment of liver and kidney function. MELD and the Charlson index are good markers of survival.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peritonitis
/
Bacterial Infections
/
Liver Cirrhosis
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Rev Esp Enferm Dig
Journal subject:
GASTROENTEROLOGIA
Year:
2018
Type:
Article