title: Predictive factors that influence the survival rates in liver cirrhosis patients with spontaneous bacterial peritonitis.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) has been known to greatly influence the survival rate of patients with liver cirrhosis. However, the factors that affect the survival rate in patients with SBP need to be clarified.
  
  
  METHODS
  This study enrolled 95 liver cirrhosis patients diagnosed with SBP. The laboratory findings of their serum and ascitic fluid were examined and the characteristics of the isolated microorganisms in their peritoneal fluid were analyzed.
  
  
  RESULTS
  The proportion of patients with culture-positive SBP was 41.1%, and 47 microorganisms were isolated from the ascitic fluid. The proportions of cultured bacteria that were Gram negative and Gram positive were 57.4% and 40.4%, respectively. The proportions of Escherichia coli, Klebsiella species, and Streptococcus species were 25.5%, 19.1%, and 19.1%, respectively. Enterococcus species represented 12.8% of the microorganisms cultured. The overall survival rates at 6, 12, and 24 months were 44.5%, 37.4%, and 32.2%, respectively. There was no relationship between the bacterial factors and the survival rate in SBP. Multivariate analysis revealed that the presence of hepatocellular carcinoma (HCC; P=0.001), higher serum bilirubin levels (≥3 mg/dL, P=0.002), a prolonged serum prothrombin time (i.e., international normalized ratio >2.3, P<0.001), renal dysfunction (creatinine >1.3 mg/dL, P<0.001), and lower glucose levels in the ascitic fluid (<50 mg/dL, P<0.001) were independent predictive factors of overall survival rate.
  
  
  CONCLUSIONS
  HCC, higher serum bilirubin levels, a prolonged serum prothrombin time, renal dysfunction, and lower ascitic glucose levels are associated with higher mortality rates in cirrhotic patients with SBP.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Pei Chuan
authors.initials: PC
authors.lastname: Tsung
authors.forename: Soo Hyung
authors.initials: SH
authors.lastname: Ryu
authors.forename: In Hye
authors.initials: IH
authors.lastname: Cha
authors.forename: Hee Won
authors.initials: HW
authors.lastname: Cho
authors.forename: Jin Nam
authors.initials: JN
authors.lastname: Kim
authors.forename: You Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Jeong Seop
authors.initials: JS
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001202:Ascitic Fluid / Q000378:metabolism / Q000382:microbiology; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis; D003404:Creatinine / Q000097:blood; D005260:Female; D005947:Glucose / Q000032:analysis; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality*; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011379:Prognosis; D011517:Prothrombin Time; D015996:Survival Rate
chemical_list: D000900:Anti-Bacterial Agents; D003404:Creatinine; D005947:Glucose; D001663:Bilirubin
keywords: Bacteria; Liver cirrhosis; Mortality; Peritonitis; Risk factors