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Related Experiment Videos

Spontaneous bacterial peritonitis in liver failure

J M Lipka1, G B Zibari, D F Dies

  • 1Department of Surgery, Louisiana State University Medical Center, Shreveport 71130-3932, USA.

The American Surgeon
|December 8, 1998
PubMed
Summary

Spontaneous bacterial peritonitis in liver failure patients has a high mortality rate (46%). A high peritoneal fluid polymorphonuclear (PMN) cell count (>1000 PMN/mm3) significantly predicts mortality in these patients.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Liver cirrhosis is a progressive hepatic injury and a leading cause of death in adults aged 35-55.
  • Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with liver failure and ascites.
  • Understanding SBP's impact on morbidity and mortality is crucial for managing liver disease patients.

Purpose of the Study:

  • To correlate morbidity and mortality of SBP in liver failure patients with various etiologic and clinical variables.
  • To identify predictors of mortality in patients with SBP and chronic liver disease.

Main Methods:

  • Retrospective review of 26 patients with SBP and chronic liver disease.
  • Analysis of demographic, clinical, and laboratory variables, including etiology, Child's classification, and ascitic fluid analysis.

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  • Statistical analysis to determine significant predictors of mortality.

    • Main Results:

    • All patients had Child's C liver disease, indicating severe liver dysfunction.
    • The overall mortality rate was 46%, with alcohol (46%) and hepatitis (30%) as primary etiologies.
    • Peritoneal fluid polymorphonuclear (PMN) cell count >1000 PMN/mm3 was the only significant predictor of mortality (P < 0.05), associated with an 88% mortality rate.

    Conclusions:

    • SBP is a critical complication with high mortality in advanced liver disease.
    • Elevated ascitic fluid PMN cell count is a strong predictor of mortality in SBP patients.
    • Few patients with SBP and liver failure are candidates for liver transplantation.