Study On The Risk Factors For Spontaneous Peritonitis In Cirrhosis

Background: Spontaneous bacterial peritonitis is the most common bacterial infection in patients with cirrhosis during liver decompensation.Its pathogenesis is complex.After reproduction,bacteria can pass through the intestinal mucosal barrier into the peritoneal cavity,causing extensive peritonitis.This can worsen the original liver disease and accelerate the death process of patients with end-stage liver disease.It also makes the patient get worse and the survival rate is reduced.It is a serious life threat to the patients.The SBP onset is insidious.Its clinical symptoms are atypical and widely different.So it’s easy to miss the diagnosis or misdiagnosis.The current methods for the diagnosis of SBP have some limitations.Therefore,rapid diagnosis and timely treatment are particularly important.This study performs statistical analysis of associated risk factors in cirrhosis with spontaneous peritonitis.The relatively independent risk factors for cirrhosis associated with SBP and the further models based on independent risk factors are obtained.This allows for the early identification and timely treatment of SBP.This can also improve the patient quality of life and prolong the survival of SBP patients with liver cirrhosis.Methods: We select cirrhotic ascites patients who were treated in the First Affiliated Hospital of Anhui Medical University from January 2016 to January 2021.A total of224 patients are accord with the diagnostic criteria and related requirements.They are divided into SBP and non-SBP groups based on the presence of ascites infection.Among them,126 people are in the SBP group and 118 in the non-SBP group,which are accord with the strict inclusion and exclusion criterias.We conduct retrospective studies on various clinical data,including their age,sex,etiology,Child-Pugh grade,WBC,NLR,MPV,PDW,PLT,ALB,TBIL,ALT,AST,CRE,CRP,NA,PT and PT-INR.We first perform a univariate test to derive the risk factors associated with the occurrence of SBP.Then the statistically significant variables are subjected to a multivariate logistic regression analysis.Independent risk factors associated with the occurrence of SBP are further concluded.A multifactor joint model based on MPV,NA,PT,CRP,AST is then developed.We can also plot the subject operating characteristic curves and analyze the area under the curve of the corresponding working characteristic curve for each index.,so as to evaluate the accuracy of SBP risk factors.The standard P<0.05 is statistically significant.Results : Our univariate analysis of various measurement data and count data suggests that age,Child-Pugh grade,WBC,NLR,MPV,PDW,ALB,TBIL,ALT,AST,CRE,CRP,NA,PT,PT-INR are associated with the SBP.Then the statistically significant variables are subjected to a multivariate logistic regression analysis.It suggests that MPV,NA,PT,CRP,and AST are independent risk factors for the occurrence of SBP in patients with cirrhosis.We develop a multifactor joint model--6.520 + 0.024 AST +0.362 PT + 0.125 CRP-0.134 NA-0.452 MPV.By drawing the ROC curve,the model is more effective to predict SBP than each independent risk factor.（AUC: 0.982,95%CI:1.622-2.013,Sensitivity: 93.2%,Speciality: 94.4%,P<0.001）.Conclusion: MPV,NA,PT,CRP,and AST are independent risk factors for SBP occurrence.The model is 6.520 + 0.024 AST + 0.362 PT + 0.125 CRP-0.134 NA-0.452 MPV ang it has the higher accuracy in assessing SBP incidence than the independent risk factors.