Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Thursday, 06 / 27 / 2019

Articles

Predictors of Spontaneous Bacterial Peritonitis in Patients with Cirrhotic Ascites

ORIGINAL ARTICLE

Predictors of Spontaneous Bacterial Peritonitis in Patients with Cirrhotic Ascites

Khaled Metwally*, Tamer Fouad, Medhat Assem, Eman Abdelsameea and Mohamed Yousery

Hepatology and Gastroenterology department, National Liver Institute, Menoufia University, Egypt

*Correspondence to: Khaled Metwally, Liver and Gastroenterology Unit, National Liver Institute, University of Menoufyia, Menofyia Governorate, Egypt. Tel: +20-100-0486019, Fax: + 20-48-2222740, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(4):372-376 DOI: 10.14218/JCTH.2018.00001
Received: January 4, 2018 Accepted: June 22, 2018 Published online: July 18, 2018

Abstract

Background and Aims: Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis and a prognostic model to predict it is needed. This study was designed to test the ability of different laboratory tests and the new scoring system by Wehmeyer and colleagues (consisting of age, C-reactive protein (CRP) and platelet count) to predict it.

Methods: Three-hundred patients admitted to the National Liver Institute, University of Menoufia, Egypt (2015–2016) with liver cirrhosis and ascites were included in our study. SBP was diagnosed if ascetic neutrophil count was ≥250/µL with no sign of secondary peritonitis.

Results: The patient population had age range of 29–81 years old, was 60% men and showed a majority (91.7%) with primary cause of liver disease being hepatitis C. By univariate analysis, associations with age, total bilirubin, aspartate aminotransferase level, creatinine level, international normalized ratio, model for end-stage liver disease score, total leucocytic count, platelet count and CRP level were significant. By multivariate analysis, independent predictors were age, platelet count and CRP level (p = 0.004, 0.013 and <0.001, respectively). CRP at a cut-off point ≥13.5 mg/L could predict SBP (sensitivity of 86.4% and specificity of 66.0%). Wehmeyer’s SBP scoring system was predictive (p < 0.001); only 4% of patients with 0 score developed SBP (CRP cut-off of 30 mg/L), while 92.8% with score of 3 or 4 developed SBP. By using our modified Wehmeyer score with CRP cut-off value of 13.5 mg/L, no patient with 0 score developed SBP.

Conclusions: Age, CRP level and platelet count are independent predictors for SBP and a scoring system including them could easily predict the condition. SBP diagnosis could be excluded in patients with 0 score, using CRP cut-off value of 13.5 mg/L.

Keywords

CRP, Predictors, SBP, Cirrhosis, Scoring

 

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 372-376  [ Html ] [ PDF Full-text ]

 

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

 logo

You are here: Home