Predictive Factors of First Episode of Spontaneous Bacterial Peritonitis in Cirrhosis

Kim, Dae Hyun; Cho, Chang Min; Keum, Min Su; Park, Eun Whee; Tak, Won Young; Kweon, Young Oh; Kim, Sung Kook; Choi, Yong Whan; Chung, Joon Mo

Abstract

BACKGROUND/AIMS: The aims of this study were to investigate the long-term probability of the first episode of spontaneous bacterial peritonitis (SBP) in cirrhosis with ascites and to identify predictive factors of this complication. We followed up 96 cirrhotic patients admitted to our hospital because of an episode of ascites without prior SBP.
RESULTS
The subjects were 76 males and 20 females and their average age was 53+/-9 years (range: 27-76 years). During the mean follow-up period of 242 days, 26 (27%) out of 96 patients had the first episode of SBP. The overall probability of this complication was 19.2% after 6 months and 39% after 1 year of follow-up. In the univariate analysis, 4 of 20 variables reached meaningful values (p<0.05) as predictive factors of the first SBP episode. These 4 variables were increased bilirubin level, decreased prothrombin activity, severity of ascites and reduced total protein concentration in ascitic fluid. When these variables were introduced in the multivariate analysis, only the severity of ascites independently correlated with the risk of SBP (p=0.0001).
CONCLUSIONS
The incidence of first episode of SBP in cirrhosis was 27% during follow-up and the most important predictive factor of SBP was the severity of ascites.