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MELD Score Is Not Related to Spontaneous Bacterial Peritonitis

Luciana Haddad1, Tatiana Morgado Conte2, Liliana Ducatti1

  • 1Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, Rua Aracaju 42, Ap. 41, 01240030 São Paulo, SP, Brazil.

Gastroenterology Research and Practice
|August 1, 2015
PubMed

Insights

The prevalence of spontaneous bacterial peritonitis (SBP) is low in cirrhotic patients with refractory ascites undergoing repeated paracentesis. The Model for End-Stage Liver Disease (MELD) score did not correlate with SBP development.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Refractory ascites is a common complication of cirrhosis.
  • Repeated paracentesis is a standard treatment for refractory ascites.
  • Spontaneous bacterial peritonitis (SBP) is a serious infection in patients with ascites.

Purpose of the Study:

  • To investigate the correlation between spontaneous bacterial peritonitis (SBP) and repeated paracentesis in cirrhotic patients with refractory ascites.
  • To examine the relationship between SBP and the Model for End-Stage Liver Disease (MELD) score.
  • To assess the incidence of SBP in an outpatient paracentesis setting.

Main Methods:

  • Prospective study of 148 cirrhotic patients with refractory ascites undergoing paracentesis.
  • Analysis of demographic data, liver disease etiology, MELD score, and liver transplant waiting list status.
  • Ascitic fluid analysis for cell count and culture to diagnose SBP.

Main Results:

  • A total of 854 paracentesis procedures were performed.
  • 28 episodes of SBP (3.3%) were diagnosed in 24 patients.
  • Patients on the liver transplant list had higher paracentesis frequency and volume drained.
  • MELD score was not found to be related to SBP.

Conclusions:

  • The prevalence of asymptomatic SBP in cirrhotic patients with refractory ascites undergoing repeated paracentesis is low.
  • MELD score is not a predictor of SBP in this patient population.
  • Outpatient paracentesis is a feasible management strategy for refractory ascites.

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