title: Creatinine modified Child-Turcotte-Pugh and integrated model of end-stage liver disease scores as predictors of spontaneous bacterial peritonitis-related in-hospital mortality: Applicable or not.
abstract: OBJECTIVE
  Despite intensive management, spontaneous bacterial peritonitis (SBP) is associated with poor prognosis especially in hospitalized patients. Therefore, the aim of this study was to determine prognostic factors for SBP-related in-hospital mortality, and to evaluate the predictive power of Child-Pugh (CP), model of end-stage liver disease (MELD), creatinine modified Child-Turcotte-Pugh (CrCTP), and integrated MELD (iMELD) for identifying the best score to predict mortality.
  
  
  METHODS
  Predictors of SBP-related in-hospital mortality were assessed using regression analysis over 100 cirrhotic patients. Predictive abilities of CP, MELD, CrCTP, and iMELD were compared using the area under receiver operating characteristic curve (AUC).
  
  
  RESULTS
  SBP-related in-hospital mortality was 22%. Age, serum creatinine, bilirubin, sodium, CrCTP, MELD, and iMELD were associated with mortality. Using AUC, CrCTP, and iMELD was significantly better than CP and MELD in predicting in-hospital mortality, where iMELD had the highest AUC (0.862). The cut-off with the best ability to predict in-hospital mortality was 43.5 for iMELD.
  
  
  CONCLUSIONS
  Age, serum creatinine, bilirubin, and sodium were associated with SBP-related in-hospital mortality. The incorporation of these variables into CP and MELD significantly improves their predictive ability. iMELD followed by CrCTP provided useful prognostic information for critically ill patients with SBP.
authors: Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors: Elham Ahmed
authors: EA
authors: Hassan
authors: Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors: Abeer Sharaf Eldin
authors: AS
authors: Abdel Rehim
mesh_terms: D001424:Bacterial Infections; D003404:Creatinine / Q000097:blood*; D058625:End Stage Liver Disease; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010538:Peritonitis / Q000382:microbiology* / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve
chemical_list: D003404:Creatinine
keywords: CrCTP; iMELD; in-hospital mortality; prognostic scores; spontaneous bacterial peritonitis