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Journal of Gastronenterology and Digestive Diseases
|
Volume 3
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
GASTROENTEROLOGY
International Conference on
PREDICTORS OF SPONTANEOUS BACTERIAL PERITONITIS IN
EGYPTIAN PATIENTS WITH CIRRHOTIC ASCITES
Khaled Metwally, Tamer Fouad, Medhat Assem, Eman Abdelsameea and Mohamed Yousery
National Liver Institute - Menoufiya University
Background:
Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis and finding a prognostic model
to predict it is needed. Objective: to test the ability of different laboratory tests and the new Wehmeyer’s SBP scoring system to
predict it.
Methods:
Three hundred patients admitted at the National Liver Institute, University of Menoufyia, Egypt (2015-2016) with
liver cirrhosis and ascites were included in our study. SBP was diagnosed if ascetic neutrophils count ≥ 250/µL with no sign of
secondary peritonitis.
Results:
Median age 56 (29 –81 years), 60%men and primary cause of liver disease was hepatitis C, 91.7%. By univariate analysis:
age, total bilirubin, AST, creatinine, international normalized ratio, MELD score, total leucocytic count, platelet count and C-reactive
protein (CRP) were significant. By multivariate analysis independent predictors were age, platelet count and CRP (p = 0.004,
0.013 and < 0.001, respectively). CRP at a cutoff point ≥ 13.5 mg/L could predict SBP (sensitivity 86.4% and specificity 66.0%).
Wehmeyer’s SBP scoring system was able to predict it (p < 0.001), only 4% of patients with 0 score developed SBP (CRP cutoff
is 30 mg/L), while 92.8% with score of 3 or 4 developed it. By using our CRP cutoff
value
of 13.5 mg/L, no patient with 0 score
developed SBP.
Conclusion:
Age, CRP and platelet count are independent predictors for SBP and a scoring system including them could easily
predict it. SBP diagnosis could be excluded in patients with zero score, using CRP cutoff value of 13.5 mg/L.
Kh_m55555@yahoo.comJ Gastroenterol Dig Dis 2018, Volume 3