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Published on: December 18, 2010

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

Maiara Isabel Musskopf1, Fabricio Pimentel Fonseca, Jeferson Gass

  • 1Gastroenterology and Hepatology Residency Program, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil.

Annals of Hepatology
|October 31, 2012
PubMed
Abstract

Insights

The integrated MELD (iMELD) score slightly improves prediction of in-hospital mortality for patients with spontaneous bacterial peritonitis (SBP). Bilirubin, creatinine, MELD, and iMELD scores are key predictors of mortality in SBP patients.

Area of Science:

  • Hepatology
  • Clinical Medicine
  • Medical Prognostics

Background:

  • Spontaneous bacterial peritonitis (SBP) carries a high in-hospital mortality rate (20-40%).
  • The Model for End-Stage Liver Disease (MELD) score is a proposed predictor for SBP mortality, but its accuracy is debated.
  • The integrated MELD (iMELD) score, incorporating age and serum sodium, aims to enhance prognostic accuracy but lacks evaluation in SBP.

Purpose of the Study:

  • To assess the accuracy of iMELD and MELD scores in predicting in-hospital mortality among SBP patients.
  • To identify additional prognostic factors for mortality in this patient cohort.

Main Methods:

  • Retrospective analysis of 40 patients diagnosed with SBP.
  • Calculation and comparison of MELD and iMELD scores.
  • Univariate analysis to identify significant predictors of in-hospital mortality.

Main Results:

  • In-hospital mortality rate was 40%.
  • Total bilirubin, creatinine, MELD, and iMELD scores were significantly associated with mortality.
  • iMELD demonstrated a slightly higher prognostic accuracy (80%) compared to MELD (77%).

Conclusions:

  • Bilirubin, creatinine, MELD, and iMELD are significant predictors of in-hospital mortality in cirrhotic patients with SBP.
  • The iMELD score offers a marginal improvement in prognostic accuracy over the MELD score for SBP patients.

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