[Spontaneous bacterial peritonitis in hepatic cirrhosis: prevalence, predictive factors and prognosis].

Peritonite bacteriana espontânea na cirrose hepática: prevalência, fatores preditivos e prognóstico.

Publisher: Associação Médica Brasileira Country of Publication: Brazil NLM ID: 9308586 Publication Model: Print Cited Medium: Print ISSN: 0104-4230 (Print) Linking ISSN: 01044230 NLM ISO Abbreviation: Rev Assoc Med Bras (1992) Subsets: MEDLINE

Original Publication: São Paulo : Associação Médica Brasileira

Bacterial Infections/*epidemiology ; Liver Cirrhosis/*complications ; Peritonitis/*epidemiology; Adult ; Aged ; Aged, 80 and over ; Ascites/complications ; Bacterial Infections/complications ; Bacterial Infections/diagnosis ; Brazil/epidemiology ; Female ; Humans ; Liver Cirrhosis, Alcoholic/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Peritonitis/complications ; Peritonitis/diagnosis ; Peritonitis/microbiology ; Predictive Value of Tests ; Prevalence ; Prognosis

Background: Spontaneous Bacterial Peritonitis (SBP) is a common and potentially fatal complication of cirrhosis. Multiple variants of this infection have been described during the past decade. Few studies have investigated SBP in Brazil.
Material and Method: In order to investigate prospectively prevalence, predictive factors and prognosis of the episode of SBP, we studied 143 in and outpatients with cirrhosis admitted to HUCFF and HUPE between January, 1995 and January, 1996. All patients were submitted to a questionnaire, physical examination, blood analysis and abdominal paracentesis with ascitic fluid analysis. They were followed for a mean follow-up period of 4 months and survival was determined.
Results: The prevalence of SBP was 20%. Culture-positive SBP, Culture-negative Neutrocytic Ascites and Bacterascites were identified in 24%, 66% and 10%, respectively. After uni- and multivariate analysis, only anterior gastrointestinal hemorrhage, serum albumin and ascitic fluid C4 reached statistical significance (p = 0.05) as predictive factors for the development of the SBP. The in-hospital and follow-up mortality rates were 33.3% and 53.8% for the SBP patients and 8.5% and 31.9% for the non-SBP patients, respectively (p = 0.01 and p = 0.04). The cumulative probability of survival in the SBP group was significantly lower than the probability of the non-SBP group (p = 0.05).
Conclusions: We conclude that SBP is a frequent complication, depends of the severity of liver failure and is a marker for poor prognosis in patients with liver cirrhosis.

Date Created: 19990722 Date Completed: 19991116 Latest Revision: 20220409

20231215

10.1590/s0104-42301999000200007

10413915