UNASSIGNED: Two hundred two consecutive patients underwent 492 paracenteses with biochemical and microbiological analysis of the ascitic fluid. When multiple paracenteses had been performed on a given patient, the first SBP-positive paracentesis or the first paracentesis conducted when none was diagnostic for SBP was included in the study.
UNASSIGNED: SBP was detected in 28 of 202 (13.9%) patients; in 26 of 28 patients, the neutrophil count in the ascitic fluid was ≥250 cells/μl, and in 15 of 28 patients, the cultures were positive. Variables independently associated with SBP were as follows: a higher model of end-stage liver disease (MELD) score, the serum glucose value, elevated CRP serum levels, and higher potassium serum levels. Overall, the median (range) transplant-free survival was 289 (54-1253) days. One hundred (49.5%) patients died, whereas 35 patients (17.3%) underwent liver transplantation. Independent predictors of death or liver transplantation were a higher MELD score and the development of SBP, especially if it was antibiotic-resistant or recurrent SBP.
UNASSIGNED: The occurrence of SBP is associated with more severe liver dysfunction in conjunction with the presence of inflammation. Unlike the occurrence of SBP per se, failure of first-line antibiotic treatment and SBP recurrence appear to strongly influence the mortality rate.
■两百名连续患者接受了492次腹水生化和微生物学分析。当对给定的患者进行了多个辅助治疗时,本研究纳入了首次SBP阳性穿刺术或无SBP诊断时进行的首次穿刺术.
■在202例患者中的28例(13.9%)中检测到SBP;在28例患者中的26例中,腹水中性粒细胞计数≥250个细胞/μl,在28名患者中,有15名患者,文化是积极的。与SBP独立相关的变量如下:终末期肝病(MELD)评分较高的模型,血清葡萄糖值,血清CRP水平升高,和更高的血清钾水平。总的来说,中位(范围)无移植生存期为289(54-1253)天.一百名(49.5%)病人死亡,而35例患者(17.3%)接受了肝移植。死亡或肝移植的独立预测因素是较高的MELD评分和SBP的发展,特别是如果它是抗生素耐药或复发性SBP。
■SBP的发生与更严重的肝功能障碍以及炎症的存在有关。与SBP本身的发生不同,一线抗生素治疗失败和SBP复发似乎对死亡率有很大影响.