Spontaneous bacterial peritonitis 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.
Dr Sonia Rito Nobre and colleagues determined the predictive value of MELD score, at admission, in the short-term mortality of spontaneous bacterial peritonitis patients.
The research team conducted a retrospective study of 73 spontaneous bacterial peritonitis episodes admitted in between 2002 and 2006.
|In-hospital mortality rate was 37%|
|European Journal of Gastroenterology & Hepatology|
Diagnosis was established within 24 hours 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.
The research team noted that in-hospital mortality rate was 37%.
In multivariate analysis, the team MELD score, and advanced age 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.
Dr Nobre’s team comments, “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.”