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Spontaneous bacterial peritonitis

J C Hoefs, H N Canawati, F L Sapico

    Hepatology (Baltimore, Md.)
    |July 1, 1982
    PubMed
    Summary
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    Spontaneous bacterial peritonitis (SBP) in patients with chronic liver disease has a high mortality rate. However, patients with less severe liver injury and higher serum bilirubin/creatinine levels showed better survival rates, suggesting prognosis depends on acute liver injury severity.

    Area of Science:

    • Hepatology
    • Infectious Diseases
    • Critical Care Medicine

    Background:

    • Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with advanced chronic liver disease.
    • Identifying prognostic factors for SBP is crucial for patient management and improving outcomes.

    Purpose of the Study:

    • To analyze the clinical characteristics and survival outcomes of patients with spontaneous bacterial peritonitis.
    • To identify predictors of rapid death and survival during hospitalization in SBP patients.

    Main Methods:

    • Retrospective analysis of 43 patients diagnosed with SBP between 1973 and 1978.
    • Criteria for SBP: positive ascites culture and polymorphonuclear cell count > 250 cells/mm³.
    • Patients categorized into two groups based on serum bilirubin and creatinine levels to assess prognosis.

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    Main Results:

    • Overall survival during hospitalization was 30% (13/43).
    • Rapid death (≤7 days) correlated with lack of prior hospitalization, hepatomegaly, and elevated bilirubin/creatinine.
    • Patients with lower bilirubin/creatinine (Group 2) had significantly better survival rates (91% vs. 29% for SBP episode; 50% vs. 9% for hospitalization) compared to Group 1.

    Conclusions:

    • Prognosis of SBP is strongly influenced by the severity of acute liver injury.
    • SBP with minimal acute liver injury has a relatively good prognosis for hospital survival, even in advanced chronic liver disease.
    • Long-term survival is possible, with 4 of 9 patients surviving 3 years in this cohort.