title: Prognostic factors associated with in-hospital mortality in patients with spontaneous bacterial peritonitis.
abstract: BACKGROUND
  Spontaneous bacterial peritonitis (SBP) is associated with a high in-hospital mortality rate ranging from 20-40%. The model for end-stage liver disease (MELD) has been suggested as a predictor of in-hospital mortality in patients with SBP. However, the accuracy of the MELD has been questioned, and the integrated MELD (iMELD) score, which incorporates age and serum sodium to the previous model, has been proposed to improve prognostic accuracy. The iMELD has not yet been evaluated in patients with SBP.
  
  
  OBJECTIVE
  To evaluate the accuracy of iMELD and MELD scores in predicting in-hospital mortality in patients with SBP and to identify other prognostic factors of mortality in this group of patients.
  
  
  RESULTS
  Of 40 patients analyzed, 65% were male, 50% had hepatitis C, and 27.5% had hepatocellular carcinoma. Mean age was 55.6 years; 25.7% were classified as Child-Pugh class B, and 74.3% as class C. Mean scores were 46.0 and 19.9 for iMELD and MELD, respectively. In-hospital mortality was 40%. Univariate analysis showed that total bilirubin, creatinine, MELD and iMELD scores were significantly associated with in-hospital mortality. The prognostic accuracy was 80% and 77% for iMELD and MELD scores, respectively.
  
  
  CONCLUSIONS
  In conclusion, bilirubin, creatinine, MELD and iMELD were predictors of in-hospital mortality in cirrhotic patients with SPB. iMELD was slightly more accurate than MELD in this group of patients.
authors.affiliation: Gastroenterology and Hepatology Residency Program, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil.
authors.forename: Maiara Isabel
authors.initials: MI
authors.lastname: Musskopf
authors.forename: Fabricio Pimentel
authors.initials: FP
authors.lastname: Fonseca
authors.forename: Jeferson
authors.initials: J
authors.lastname: Gass
authors.forename: Angelo Zambam
authors.initials: AZ
authors.lastname: de Mattos
authors.forename: Jorge Alberto
authors.initials: JA
authors.lastname: John
authors.forename: Ajácio Bandeira
authors.initials: AB
authors.lastname: de Mello Brandão
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality*; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine; D001663:Bilirubin