title: The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) contributes to poorer short-term mortality in cirrhotic patients with ascites. However, it is unknown how long the effect of the first SBP event persists in these patients.
  
  
  METHODS
  The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify and enroll 7,892 cirrhotic patients with ascites who were hospitalized between January 1 and December 31, 2007. All patients were free from episodes of SBP from 1996 to 2006.
  
  
  RESULTS
  The study included 1,176 patients with SBP. The overall 30-day, 90-day, 1-year, and 3-year mortality rates in this group were 21.8%, 38.9%, 57.5%, and 73.4%, respectively. The overall 30-day, 90-day, 1-year, and 3-year mortality rates in the non-SBP group were 15.7%, 32.5%, 53.3%, and 72.5%, respectively. After adjusting for gender, age, and other medical comorbidities, the adjusted hazard ratios of SBP for 30-day, 30- to 90-day, 90-day to 1-year, and 1- to 3-year mortality were 1.49 (95% confidence interval [CI], 1.30 to 1.71), 1.19 (95% CI, 1.02 to 1.38), 1.04 (95% CI, 0.90 to 1.20), and 0.90 (95% CI, 0.77 to 1.05), respectively, compared with the non-SBP group.
  
  
  CONCLUSIONS
  The effect of SBP on the mortality of cirrhotic patients with ascites disappeared in those surviving more than 90 days after the first SBP event.
authors: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors: Tsung-Hsing
authors: TH
authors: Hung
authors: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors: Chen-Chi
authors: CC
authors: Tsai
authors: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors: Yu-Hsi
authors: YH
authors: Hsieh
authors: Department of Mathematics, Tamkang University, Tamsui, Taiwan.
authors: Chih-Chun
authors: CC
authors: Tsai
authors: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors: Chih-Wei
authors: CW
authors: Tseng
authors: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors: Kuo-Chih
authors: KC
authors: Tseng
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000382:microbiology / Q000401:mortality*; D001424:Bacterial Infections / Q000150:complications / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000382:microbiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000382:microbiology / Q000401:mortality*; D016016:Proportional Hazards Models; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
keywords: Ascites; Cirrhosis; Mortality; Spontaneous bacterial peritonitis