A team from Baltimore, Maryland, USA, investigated the outcome of all patients admitted to Maryland hospitals with spontaneous bacterial peritonitis (SBP) from 1988 to 1998.
SBP is a complication of end-stage liver disease with a reported mortality of 30-50%.
Main outcomes considered included trends in survival rates over time, changes in the length of stay, total health care costs, and variables that predicted survival rates.
|Mean costs for SBP patient:|
|American Journal of Gastroenterology|
The Maryland Health Services Cost Review database of all patients admitted to Maryland hospitals from 1988 to 1998 with both peritonitis and cirrhosis was used to identify relevant individuals.
A total of 348 patients were admitted, with an in-hospital mortality of 32.6%; there was no significant change in mortality rate during this period.
The survival rate was found to be similar in the university and community hospitals.
In the logistic regression analysis, age and intensive care unit stay were found to significantly influence the survival rates. Patients who had an intensive care unit stay were 2.8 times more likely to die than those who did not have an intensive care unit stay, controlling for age.
The average length of hospital stay remained unchanged (13.5 days) during the study period.
The researchers found that, although the median hospital charge (excluding professional fees) remained unchanged, mean inflation-adjusted charges increased from $7,897 in 1988 to $25,902 in 1998.
Dr Paul J. Thuluvath, of the Johns Hopkins University School of Medicine, concluded on behalf of the group, "The mortality rate associated with SBP has remained unchanged over an 11-year period from 1988 to 1998. The mortality showed a strong correlation with age and intensive care unit stay.
"The median hospital stay and median charges remained unchanged during this period, but mean costs increased significantly because of increased use of resources by a few patients."