title: Factors Affecting Mortality and Morbidity of Patients With Cirrhosis Hospitalized for Spontaneous Bacterial Peritonitis.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis, unless originating from surgery or an intra-abdominal source, is an infection diagnosed by neutrophil counts greater than 250/mm³ in ascites. Spontaneous bacterial peritonitis is the most common infection among patients hospitalized with cirrhosis, with a prevalence of 9% and a risk of development among all patients with cirrhosis within 1 year of 10%. No valid parameters have been defined to predict the mortality related to spontaneous bacterial peritonitis. Unless it is treated, the mortality rate as a result of spontaneous bacterial peritonitis is 50%, and serious complications may arise.
  
  
  METHODS
  Medical records from 29 patients on the deceased-donor transplant waiting list and receiving treatment at the Başkent University Hospital Gastroenterology Clinic for cirrhotic ascites infection between 1996 and 2013 were analyzed. Demographic information, paracentesis findings, clinical follow-up, and treatment results were reviewed and collected from patient medical records, with data recorded to the research form.
  
  
  RESULTS
  In our patient group, 72.4% were men and the average age was 46.6 years. Most of our patients were at advanced stage, with 55.2% having a Child-Pugh score of C and an average Model for End-Stage Liver Disease score of 17 ± 4.1. We found that 34.5% of the patients received prophylactic treatment for spontaneous bacterial peritonitis, 72.4% received a proton pump inhibitor, and 82.8% had treatment with intravenous albumin support at the time of diagnosis. Albumin treatment showed no effect on mortality. Mortality rate among patients with Child-Pugh score of C was 81.3%.
  
  
  CONCLUSIONS
  Existence of chronic renal failure, liver graft surgery, and hepatocellular cancer did not seem to have a significant effect on patient mortality. The albumin treatment protocol showed no significant difference despite common belief among physicians.
authors.affiliation: From the Department of Gastroenterology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ensaroğlu
authors.forename: Murat
authors.initials: M
authors.lastname: Korkmaz
authors.forename: Ali Ümit
authors.initials: AÜ
authors.lastname: Geçkil
authors.forename: Serkan
authors.initials: S
authors.lastname: Öcal
authors.forename: Bengisu
authors.initials: B
authors.lastname: Koç
authors.forename: Özgün
authors.initials: Ö
authors.lastname: Yıldız
authors.forename: Fatma Büşra
authors.initials: FB
authors.lastname: Atalay
authors.forename: Emine Gül
authors.initials: EG
authors.lastname: Taş
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000418:Albumins / Q000008:administration & dosage; D001201:Ascites / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000628:therapy; D001424:Bacterial Infections / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000628:therapy; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D019152:Paracentesis; D010538:Peritonitis / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000628:therapy; D054328:Proton Pump Inhibitors; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014421:Turkey; D014850:Waiting Lists / Q000401:mortality
chemical_list: D000418:Albumins; D054328:Proton Pump Inhibitors