Analysis of Risk Factors for Patients with Liver Cirrhosis Complicated with Spontaneous Bacterial Peritonitis
Abstract
Background: We aimed to explore risk factors for patients with liver cirrhosis complicated with spontaneous bacterial peritonitis (SBP).
Methods: The clinical data of 195 patients with liver cirrhosis complicated with SBP (study group), admitted from March 2014 to March 2018 in Tianjin Medical University General Hospital, Tianjin, China and 195 patients without liver cirrhosis complicated with SBP (control group) were retrospectively analyzed. Clinical manifestations of patients and laboratory findings were analyzed. Univariate and multivariate Logistic regression analysis were used for independent risk factors for the occurrence of SBP.
Results: There were significant differences in patients between study group and control group in Child-Pugh classification, peripheral blood white blood cell (WBC), serum C-reactive protein (CRP), serum total bilirubin (TBil), ascites WBC, ascites albumin (ALB), and the ratio of complicated with upper gastrointestinal hemorrhage, hepatorenal syndrome, hepatic encephalopathy and hyponatremia (P<0.01); Logistic regression analysis found that Child-Pugh classification, serum CRP, ascites WBC, ascites ALB, upper gastrointestinal hemorrhage, hepatorenal syndrome, hepatic encephalopathy and hyponatremia were related to the occurrence of SBP; and Child-Pugh classification, ascites ALB, upper gastrointestinal hemorrhage, hepatorenal syndrome and hyponatremia were its independent risk factors.
Conclusion: Child-Pugh classification, ascites ALB, upper gastrointestinal hemorrhage, hepatorenal syndrome and hyponatremia are independent risk factors for the occurrence of liver cirrhosis complicated with SBP. Cautions should be raised for patients with liver cirrhosis for this. In the early stage, we should make effective antibiotic anti-bacterial infection program, actively prevent and control the occurrence of SBP, improving the survival rate of patients.
2. Schwab S, Lehmann J, Lutz P et al (2017). Influence of genetic variations in the SOD1 gene on the development of asci-tes and spontaneous bacterial peritonitis in decompensated liver cirrhosis. Eur J Gastroenterol Hepatol, 29: 800-804.
3. Cullaro G, Kim G, Pereira MR, Brown RS, Jr. Verna EC (2017). Ascites Neutrophil Gelatinase-Associated Lipocalin Identifies Spontaneous Bacterial Peritonitis and Predicts Mortality in Hospitalized Patients with Cirrhosis. Dig Dis Sci, 62: 3487-3494.
4. Jepsen P, Vilstrup H, Moller JK, Sorensen HT (2003). Prognosis of patients with liv-er cirrhosis and spontaneous bacterial peritonitis. Hepatogastroenterology, 50: 2133-2136.
5. Woodhouse C, Shawcross DL (2018). Edi-torial: rifaximin-a kick in the gut for spontaneous bacterial peritonitis? Aliment Pharmacol Ther, 47: 301-303.
6. Fernandez J, Acevedo J, Arroyo V (2017). Response to the clinical course and short-term mortality of cirrhotic patients with non-spontaneous bacterial peritoni-tis infections. Liver Int, 37: 623.
7. Shi L, Wu D, Wei L et al (2017). Corrigen-dum: Nosocomial and Community-Acquired Spontaneous Bacterial Peritoni-tis in patients with liver cirrhosis in Chi-na: Comparative Microbiology and Ther-apeutic Implications. Sci Rep, 7: 46868.
8. Andreu M, Sola R, Sitges-Serra A et al (1993). Risk factors for spontaneous bac-terial peritonitis in cirrhotic patients with ascites. Gastroenterology, 104: 1133-1138.
9. Sideris A, Patel P, Charles HW, Park J, Feldman D, Deipolyi AR (2017). Imaging and clinical predictors of spontaneous bacterial peritonitis diagnosed by ultra-sound-guided paracentesis. Proc (Bayl Univ Med Cent), 30: 262-264.
10. Lata J, Stiburek O, Kopacova M (2009). Spontaneous bacterial peritonitis: a severe complication of liver cirrhosis. World J Gastroenterol, 15: 5505-5510.
11. Lutz P, Nischalke HD, Kramer B et al (2017). Antibiotic resistance in healthcare-related and nosocomial spontaneous bac-terial peritonitis. Eur J Clin Invest, 47: 44-52.
12. Marciano S, Dirchwolf M, Bermudez CS et al (2018). Spontaneous bacteremia and spontaneous bacterial peritonitis share similar prognosis in patients with cirrho-sis: a cohort study. Hepatol Int, 12: 181-190.
13. Zhang JM and Weng XH (2005). [Diagno-sis, treatment and prophylaxis of sponta-neous bacterial peritonitis]. Zhonghua Gan Zang Bing Za Zhi, 13: 459-460.
14. Niu B, Kim B, Limketkai BN, Sun J, Li Z, Woreta T, Chen PH (2018). Mortality from Spontaneous Bacterial Peritonitis Among Hospitalized Patients in the USA. Dig Dis Sci, 63: 1327-1333.
15. Granito A, Bolondi L (2017). Non-transplant therapies for patients with hepatocellular carcinoma and Child-Pugh-Turcotte class B cirrhosis. Lancet Oncol, 18: e101-e112.
16. Lutz P, Goeser F, Kaczmarek DJ et al (2017). Relative Ascites Polymorphonu-clear Cell Count Indicates Bacterascites and Risk of Spontaneous Bacterial Peri-tonitis. Dig Dis Sci, 62: 2558-2568.
17. Na SH, Kim EJ, Nam EY et al (2017). Comparison of clinical characteristics and outcomes of spontaneous bacterial peri-tonitis and culture negative neutrocytic as-cites. Scand J Gastroenterol, 52: 199-203.
18. Mai M, Stengel S, Al-Herwi E, Peter J, Schmidt C, Rubio I, Stallmach, Bruns T (2017). Genetic variants of TRAF6 modulate peritoneal immunity and the risk of spontaneous bacterial peritonitis in cirrhosis: A combined prospective-retrospective study. Sci Rep, 7: 4914.
19. Thomson MJ, Tapper EB, Lok ASF (2018). Dos and Don'ts in the Management of Cirrhosis: A View from the 21st Century. Am J Gastroenterol, 113 (7):927-931.
20. Lee S, Saxinger L, Ma M et al (2017). Bacte-rial infections in acute variceal hemor-rhage despite antibiotics-a multicenter study of predictors and clinical impact. United European Gastroenterol J, 5: 1090-1099.
21. Kwon JH, Koh SJ, Kim W et al (2014). Mortality associated with proton pump inhibitors in cirrhotic patients with spon-taneous bacterial peritonitis. J Gastroenterol Hepatol, 29: 775-781.
| Files | ||
| Issue | Vol 47 No 12 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Liver cirrhosis Spontaneous bacterial peritonitis Risk factor Bacterial culture | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
