P-13 IMPACT OF SPONTANEOUS BACTERIAL PERITONITIS ON THE OUTCOME OF PATIENTS WITH HEPATIC CIRRHOSIS

Introduction and Objectives

Spontaneous bacterial peritonitis (SBP) increases mortality, making it relevant to evaluate factors that negatively impact the outcome of patients who develop SBP. This study aimed to evaluate SBP as a risk factor in the outcome of patients with cirrhosis.

Materials and Methods

A retrospective and analytical study was conducted on patients with cirrhosis who developed SBP. The cause of cirrhosis, Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, and MELD-Na score were evaluated. They were classified into early responders (ER) (more than 25% decrease in polymorphonuclear cells on the second day of effective antibiotic treatment), development of renal injury (RI), acute-on-chronic liver failure (ACLF), and 28-day mortality. Statistical analysis included evaluating the mortality rate using the Kaplan-Meier curve, log-rank test, considering significance at p 0.05. RI, ACLF, and non-early responders were independently compared.

Results

A total of 79 patients were included, 40 males (50.63%). The most common etiology was alcohol-related in 39 cases (49.36%), and Child-Pugh class C was observed in 67 cases (84.81%). Cephalosporins were used in 66 cases (83.54%), and carbapenems in 13 cases (16.45%). There were 6 deaths among early responders and 29 deaths among non-early responders, with a mean survival of 25.76 days for early responders versus 9.78 days for non-early responders, p < 0.001 (fig1). There were 2 deaths without ACLF and 33 deaths with ACLF, with a mean survival of 26.93 days without ACLF versus 14.6 days with ACLF, p < 0.001. There were 3 deaths without renal injury and 32 deaths with RI, with a mean survival of 25.65 days without RI versus 16.17 days with RI, p < 0.001.

Conclusions

SBP is associated with a high mortality rate. However, treatment response, the presence of ACLF, and RI have a significant impact on patient survival.