Spontaneous bacterial peritonitis has no effect on the long-term prognosis of cirrhosis patients with ascites.

Abstract

INTRODUCTION AND OBJECTIVES:

Spontaneous bacterial peritonitis (SBP) is a frequent complication to cirrhosis with an unclear long-term prognosis. We aimed to examine its effect on mortality in two independent patient cohorts.

PATIENTS AND METHODS:

We used Danish healthcare data on cirrhosis patients with a first-time paracentesis in 2000-2014 and data from three randomized controlled trials on satavaptan treatment of ascites conducted in 2006-2008. We used the Kaplan-Meier method to estimate cumulative mortality, and Cox regression to compare the confounder-adjusted mortality hazard for patients with vs. without SBP.

RESULTS:

In the Danish Healthcare Cohort, we included 1.282 patients of whom 133 (10.4%) had SBP. The SBP patients' cumulative 4-month mortality was 51.2% (95% CI: 43.0-59.9%) vs. 34.7% (95% CI: 32.0-37.6) in those without SBP. The SBP patients' confounder-adjusted mortality hazard was 1.54-fold higher (95% CI: 1.18-2.00) in the four months after paracentesis, but was not increased thereafter (confounder-adjusted mortality hazard 1.02, 95% 0.72-1.46). In the satavaptan trial data of 1,198 cirrhosis patients with ascites, the 93 patients with SBP had a cumulative 4-month mortality of 38.6% (95% CI: 29.3-49.7) compared with 11.4% (95% CI: 8.5-15.2) in those without. The SBP patients' confounder-adjusted mortality hazard ratio was 3.86 (95% CI: 2.44-6.12) during the first four months, and was 1.23 (95% CI: 0.54-2.83) thereafter.

CONCLUSIONS:

In both cohorts of patients with cirrhosis, an SBP episode had a high short-term mortality compared to patients without SBP, and had no lasting effect on the long-term mortality.

• Authors: Thomas Deleuran, Hugh Watson, Hendrik Vilstrup, Peter Jepsen
• Journal: Annals of hepatology (Ann Hepatol) 2022 Jul-Aug Vol. 27 Issue 4 Pg. 100711 ISSN: 1665-2681 [Print] Mexico
• PMID: 35447366 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.

Topics

• Ascites (etiology)
• Bacterial Infections (diagnosis, drug therapy)
• Humans
• Liver Cirrhosis (complications, diagnosis)
• Peritonitis (diagnosis, drug therapy)
• Prognosis
• Randomized Controlled Trials as Topic
• Risk Factors