Risk factors for spontaneous bacterial peritonitis in cirrhotic patients with ascites.
BACKGROUND
This study was performed to investigate the risk factors for a first episode of spontaneous bacterial peritonitis in cirrhotic patients.


METHODS
One hundred ten cirrhotics with sterile ascites, without previous spontaneous bacterial peritonitis (SBP), were included from March 1988 to October 1989 and followed up until October 1990 (follow-up, 46 +/- 3.5 weeks; range, 4-120 weeks).


RESULTS
Twenty-eight patients (25.45%) suffered SBP. In multivariate analysis (Cox's regression model) including only variables commonly used in clinical practice, ascitic fluid protein concentration and serum bilirubin level independently correlated with first SBP development. Using these two variables the relative risk of a first SBP episode was calculated for each patient. According to the median relative risk coefficient (1.2), a low-risk group (relative risk, < 1.2) and a high-risk group (relative risk, > 1.2) were established. Kaplan-Meier estimates of patients free of SBP were significantly higher in the low-risk group.


CONCLUSIONS
The probability of a first SBP episode is significantly influenced by the antimicrobial capacity of ascitic fluid and hepatic function.
Andreu
M
M
Service of Gastroenterology, Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Spain.
Sola
R
R
Sitges-Serra
A
A
Alia
C
C
Gallen
M
M
Vila
M C
MC
Coll
S
S
Oliver
M I
MI
D001201:Ascites; D001424:Bacterial Infections / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D001663:Bilirubin / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D003165:Complement System Proteins / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D015999:Multivariate Analysis; D010538:Peritonitis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D010976:Platelet Count; D011336:Probability; D011446:Prospective Studies; D011516:Prothrombin / Q000032:analysis; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
D001798:Blood Proteins; D007136:Immunoglobulins; D011516:Prothrombin; D003165:Complement System Proteins; D001663:Bilirubin