Analysis Of Prognostic Factors For Spontaneous Bacterial Peritonitis In Cirrhotic Patients

Objective:Spontaneous bacterial peritonitis (SBP) is one of the most frequent and severe complications of cirrhotic patients with ascites. The development of SBP could induce a poor prognosis, and the mortality rate is high, prognostic factors is an issue in discussion, the objective of this study is to investigate the prognostic factors for spontaneous bacterial peritonitis in cirrhotic patients, and to provide proof for patient's condition and prognosis evaluation.Methods:130 cases of hospitalized cirrhotic patients with SBP were collected. The patients were divided into improved group and deteriorated group. Their clinical data including age, gender, SBP history, cause of cirrhosis, lower blood pressure, serious hyponatremia, hyperbilirubinemia, pulse> 100, upper gastrointestinal hemorrhage, hepatic encephalopathy, hepato-renal syndrome, diabetes, serum albumin, prothromtin time (PT), ascetic fluid total protein, ascetic fluid leukocyte number, Child-pugh class, ascetic culture were documented. First, all variables were examined by chi-square test, and those with statistical significance in univariate analysis were examined with a multivariate analysis using Binary logistic regression.Results:1. The results of ascites culture:The ascetic fluid culture was positive in 25 patients(19.2%). 2. Prognosis:Among the 130 cases with SBP,85 cases were cured or improvement, 45 cases were deterioration or died, the mortality rate was 34.6%.3. Investigation the prognostic factors:Univariate analysis identified significant differences between the two groups with regard to SBP history, upper gastrointestinal hemorrhage, hepatic encephalopathy, hepato-renal syndrome, lower blood pressure, serious hyponatremia, hyperbilirubinemia, pulse> 100, Child-pugh class. There were no statistical differences in age, gender, cause of cirrhosis, serum albumin, ascetic fluid total protein, ascetic fluid leukocyte number, prothromtin time (PT), diabetes, ascetic culture between the two groups. On the logistic regression analysis, SBP history, hepato-renal syndrome, lower blood pressure, pulse> 100, Child-pugh class were selected as significant independent factors of prognosis.Conclusions:1. The positive rate of ascites culture is low, the recurernce rate is high, the mortality rate is high and the prognosis is bad in the patients with SBP.2. SBP history, hepato-renal syndrome, lower blood pressure, pulse> 100, Child-pugh class were significant independent factors of prognosis and may be useful to guide clinical treatment.