Risk of a first community-acquired spontaneous bacterial peritonitis in cirrhotics with low ascitic fluid protein levels
Section snippets
Patients and methods
One hundred nine cirrhotic patients with low ascitic fluid total protein levels (≤1g/dL) and without a previous episode of SBP, admitted to the Hospital del Mar or the Hospital de la Santa Creu i Sant Pau in Barcelona between January 1994 and December 1995, were included in the study after discharge from the hospital. Exclusion criteria were severe hepatic insufficiency (serum bilirubin concentration >15 mg/dL), advanced renal dysfunction (serum creatinine concentration >3 mg/dL), or evidence
Results
One hundred nine patients with low ascitic fluid total protein levels (≤1 g/dL) and without a previous episode of SBP were included in the study. Sixty patients were from the Hospital del Mar and 49 from the Hospital Sant Pau. During a mean follow-up of 45 weeks (range, 4-143 weeks), 28 patients developed an episode of SBP. Nine ascitic fluid infections were acquired during a hospitalization. Clinical and analytical characteristics of patients are shown in Table 1.
Discussion
Previous studies have shown that the incidence of SBP is higher in patients with ascitic fluid total protein levels ≤1 g/dL than in patients with a protein concentration in ascitic fluid of >1 g/dL, not only during the hospitalization24, 25 but also during long-term follow-up.15, 17 Between 15% and 30% of cirrhotic patients with low ascitic fluid total protein levels are infected at admission or develop an episode of SBP during hospitalization.24, 25 In addition, the cumulative probability of
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Use of prokinetic agents or antibiotics is associated with the occurrence of spontaneous bacterial peritonitis in cirrhotic patients
2018, Journal of the Chinese Medical AssociationCitation Excerpt :Since the occurrence of SBP markedly worsens the prognosis in cirrhotic patients, numerous researches have studied the risk factors associated with the occurrence of SBP. In addition to the well established risk factors such as advanced liver dysfunction,6,7 gastrointestinal (GI) bleeding and low ascitic protein,8,9 medications may also affect the chances of developing SBP. The use of acid suppressive therapy including proton pump inhibitors (PPIs) or H2 receptor antagonist (H2RA) has been found to have a potential association with the occurrence of SBP.10–12
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