Gut Liver.  2016 Sep;10(5):803-807. 10.5009/gnl13468.

The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan

Affiliations
  • 1Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan. antibody_1@msn.com
  • 2School of Medicine, Tzu Chi University, Hualien, Taiwan.
  • 3Department of Mathematics, Tamkang University, Tamsui, Taiwan.

Abstract

BACKGROUND/AIMS
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.

Keyword

Cirrhosis; Spontaneous bacterial peritonitis; Ascites; Mortality

MeSH Terms

Adult
Aged
Ascites/microbiology/*mortality
Bacterial Infections/complications/*mortality
Comorbidity
Female
Hospitalization/statistics & numerical data
Humans
Liver Cirrhosis/microbiology/*mortality
Male
Middle Aged
Peritonitis/microbiology/*mortality
Proportional Hazards Models
Survival Rate
Taiwan/epidemiology
Time Factors
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