Document Detail


In-hospital mortality in spontaneous bacterial peritonitis: a new predictive model.
MedLine Citation:
PMID:  18941414     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotics with ascites. Early identification of high-risk patients is crucial for prognostic improvement. Model for end-stage liver disease (MELD) relies on a few objective variables and predicts short-term survival. We aimed to determine the predictive value of MELD score, at admission, in the short-term mortality of SBP patients. METHODS: We conducted a retrospective study of 73 SBP episodes admitted in our department between January 2002 and April 2006. Diagnosis (neutrophil count in ascitic fluid >or=250/mm3) was established within 24 h and cefotaxime was immediately started. Data collected included age, sex, etiology of liver disease, severity of ascites and hepatic encephalopathy, serum creatinine, total bilirubin and albumin, prothrombin time with international normalized ratio, and ascitic fluid analysis. STATISTICS: Student's t-test, chi2 test, univariate analysis, logistic regression model, and receiver operating characteristic curves. RESULTS: In-hospital mortality rate was 37%. In multivariate analysis, MELD score (P<0.001), and advanced age (P<0.05) were independent predictors of mortality. Receiver operating characteristic curve for MELD score revealed an excellent discriminatory ability to predict death, with an area under curve of 0.84. Age increased the predictive ability of MELD score, represented by an increment of area under curve to 0.88. CONCLUSION: MELD score and older age were independent predictors of mortality. Age increased the discriminatory ability of MELD score to predict death. This new model may be useful for stratifying patients in future therapeutic trials, deserving further validation.
Authors:
Sónia Rito Nobre; José Eduardo Pina Cabral; João José Ferreira Gomes; Maximino Correia Leitão
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  20     ISSN:  1473-5687     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-07     Completed Date:  2008-12-22     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1176-81     Citation Subset:  IM    
Affiliation:
Unit of Gastroenterology, Hospital Center of Cascais, Cascais, Portugal. soninobre@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Bacterial Infections / complications*
Cross Infection / complications*
Epidemiologic Methods
Female
Humans
Liver Cirrhosis / complications*
Liver Failure / complications
Male
Middle Aged
Opportunistic Infections / complications*
Peritonitis / complications*
Prognosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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