Prognostic factors of liver cirrhosis mortality after a first episode of spontaneous bacterial peritonitis. A multicenter study

Luigi Melcarne, Julia Sopeña, Francisco José Martínez-Cerezo, Mercedes Vergara, Mireia Miquel, Jordi Sánchez-Delgado, Blai Dalmau, Salvador Machlab, Dustin Portilla, Yonaisy González-Padrón, Mónica Real-Álvarez, Chantal Carpintero, Meritxell Casas

Research output: Contribution to journalArticleResearchpeer-review

Abstract

© 2018, ARAN Ediciones S.A.. All rights reserved. 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 and methods: 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.
Original languageEnglish
Pages (from-to)94-101
JournalRevista Espanola de Enfermedades Digestivas
Volume110
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • Acute kidney injury
  • Antibiotic prophylaxis
  • Hepatic encephalopathy
  • Liver cirrhosis
  • Mortalities
  • Proton pump inhibitors
  • Spontaneous bacterial peritonitis

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