Abstract

MATHURIN LASAVE, Sebastián Alfonso; AGUERO LOPEZ, Andrés Pablo; SPANEVELLO PETRIN, Valeria Adriana  and  CHAPELET CISI, Adrián Gustavo. Prevalence, clinical aspects and prognosis of spontaneous bacterial peritonitis in a general hospital. Rev cubana med [online]. 2008, vol.47, n.4. ISSN 0034-7523.

A descriptive and retrospective study was conducted to analyze the prevelence or spontaneous bacterial peritonitis, clinical manifestations, microbiological characteristics and prognostic factors for mortality in 218 admissions of 125 patients with cirrhosis and ascites between April 2004 and May 2008. A univariate analysis was made by the Student's t test and Fisher's exact test. The logistical regression method was used to determine factors associated with mortality. 39 episodes of spontaneous bacterial peritonitis in 39 patients were included, 83.8 % were males, average age was 49.1 and 93.6 % were alcoholic, with a prevalence of 39/218 (17.9 %). 10 patients died (32.2 %). It was community acquired in 59 % and symptomatic in 82 %. 41 % had a positive culture of ascitic fluid. 13/24 (54 %) positive cultures of ascitic fluid and/or hemocultures were by gram-posistive germs. Child-Pügh's score, Glasgow's score of alcoholic hepatitis, site of acquisition, hepatic encephalopathy, control by paracentesis at 48 h of the beginning of antibiotics without response, presence of septic shock, renal failure, hyponatremia and total bilirubinemia > 250 µmol/L (> 14,6 mg/dL) were identified as the predictor factors in the univariate analysis. The presence of septic shock, total bilirubinemia > 250 µmol/L and creatininemia > 114.4 µmol/L (> 1.5 mg/dL) were the independent prognostic factors for mortality, the first two increased more than 20 times the risk of death and 14 times the renal failure.

Keywords : Liver cirrhosis; ascites; spontaneous bacterial peritonitis; prognostic factors; mortality.

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