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Exp Clin Transplant ; 13 Suppl 3: 131-6, 2015 Nov.
Article de Anglais | MEDLINE | ID: mdl-26640933

RÉSUMÉ

OBJECTIVES: Spontaneous bacterial peritonitis, unless originating from surgery or an intra-abdominal source, is an infection diagnosed by neutrophil counts greater than 250/mm³ in ascites. Spontaneous bacterial peritonitis is the most common infection among patients hospitalized with cirrhosis, with a prevalence of 9% and a risk of development among all patients with cirrhosis within 1 year of 10%. No valid parameters have been defined to predict the mortality related to spontaneous bacterial peritonitis. Unless it is treated, the mortality rate as a result of spontaneous bacterial peritonitis is 50%, and serious complications may arise. MATERIALS AND METHODS: Medical records from 29 patients on the deceased-donor transplant waiting list and receiving treatment at the Baskent University Hospital Gastroenterology Clinic for cirrhotic ascites infection between 1996 and 2013 were analyzed. Demographic information, paracentesis findings, clinical follow-up, and treatment results were reviewed and collected from patient medical records, with data recorded to the research form. RESULTS: In our patient group, 72.4% were men and the average age was 46.6 years. Most of our patients were at advanced stage, with 55.2% having a Child-Pugh score of C and an average Model for End-Stage Liver Disease score of 17 ± 4.1. We found that 34.5% of the patients received prophylactic treatment for spontaneous bacterial peritonitis, 72.4% received a proton pump inhibitor, and 82.8% had treatment with intravenous albumin support at the time of diagnosis. Albumin treatment showed no effect on mortality. Mortality rate among patients with Child-Pugh score of C was 81.3%. CONCLUSIONS: Existence of chronic renal failure, liver graft surgery, and hepatocellular cancer did not seem to have a significant effect on patient mortality. The albumin treatment protocol showed no significant difference despite common belief among physicians.


Sujet(s)
Ascites/mortalité , Infections bactériennes/mortalité , Maladie du foie en phase terminale/mortalité , Hospitalisation , Cirrhose du foie/mortalité , Péritonite/mortalité , Administration par voie intraveineuse , Adulte , Sujet âgé , Albumines/administration et posologie , Ascites/diagnostic , Ascites/microbiologie , Ascites/thérapie , Infections bactériennes/diagnostic , Infections bactériennes/microbiologie , Infections bactériennes/thérapie , Maladie du foie en phase terminale/diagnostic , Maladie du foie en phase terminale/étiologie , Maladie du foie en phase terminale/chirurgie , Femelle , Hôpitaux universitaires , Humains , Cirrhose du foie/complications , Cirrhose du foie/diagnostic , Cirrhose du foie/chirurgie , Transplantation hépatique/mortalité , Mâle , Dossiers médicaux , Adulte d'âge moyen , Paracentèse , Péritonite/diagnostic , Péritonite/microbiologie , Péritonite/thérapie , Inhibiteurs de la pompe à protons , Enregistrements , Études rétrospectives , Facteurs de risque , Indice de gravité de la maladie , Résultat thérapeutique , Turquie , Listes d'attente/mortalité
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