title: Relationship between the degree of portal hypertension and the onset of spontaneous bacterial peritonitis in patients with cirrhosis.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhosis but its exact pathogenesis has not yet been elucidated and the role of portal hypertension in the development of SBP has been suggested. The aim of this study was to test the hypothesis that an association exists between the degree of portal hypertension and the occurrence of SBP.
  
  
  METHODS
  292 patients with cirrhosis who underwent a measurement of the hepatic venous pressure gradient (HVPG) were retrospectively studied. Following their ascites profile, patients were classified in three groups: patients with ascites who suffered from SBP, patients with sterile ascites, and patients who had no ascites.
  
  
  RESULTS
  Among the 137 patients with ascites, 24 patients suffered from SBP (17.5%). The mean HVPG was significantly different: 20.7 +/- 6.2 mm Hg in the SBP group, 17.5 +/- 5.1 mm Hg in the sterile ascites group and 14.7 +/- 5.6 mm Hg in the group without ascites (p < 0.05). Patients with the most severe portal hypertension (HVPG > or =30 mm Hg) had the highest risk to suffer from SBP (50%). Using the multivariate analysis, only the serum albumin level (p = 0.004) and the HVPG (p = 0.02) were independently correlated with the occurrence of ascites infection.
  
  
  CONCLUSIONS
  This study suggests that in patients with SBP the degree of portal hypertension is greater than in the non infected patients. Ascites infection is independently associated with a low serum albumin level and a high HVPG.
authors.affiliation: Department of Gastroenterology, ULB Erasme University Hospital, Brussels, Belgium. thomas.serste@skynet.be
authors.forename: Thomas
authors.initials: T
authors.lastname: Sersté
authors.forename: Nadine
authors.initials: N
authors.lastname: Bourgeois
authors.forename: Didier
authors.initials: D
authors.lastname: Lebrec
authors.forename: Sylvie
authors.initials: S
authors.lastname: Evrard
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Moine
mesh_terms: D001201:Ascites / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D001424:Bacterial Infections / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D001774:Blood Chemical Analysis; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D017082:Portal Pressure / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors