Kalpit Devani1, Paris Charilaou2, Palashkumar Jaiswal3, Nirav Patil4, Dhruvil Radadiya5, Pranav Patel6, Mark Young1, Don C Rockey7, Chakradhar M Reddy1. 1. Department of Internal Medicine, Division of Gastroenterology, East Tennessee State University, Johnson City, TN. 2. Department of Internal Medicine, Saint Peter's University Hospital, New Brunswick, NJ. 3. Department of Internal Medicine, John Stroger Hospital of Cook County, Chicago, IL. 4. Greenville Health System, Greenville. 5. Emory University School of Medicine, Atlanta, GA. 6. Division of Gastroenterology, University of Alabama at Birmingham (UAB), Montgomery, AL. 7. Department of Internal Medicine, Division of Gastroenterology, Medical University of South Carolina, Charleston, SC.
Abstract
GOALS: The purpose of our study was to evaluate trends of hospitalization, acute kidney injury (AKI) and mortality in cirrhotic patients with spontaneous bacterial peritonitis (SBP). BACKGROUND: SBP is a frequent bacterial infection in cirrhotic patients leading to increased morbidity and mortality. MATERIALS AND METHODS: A total of 4,840,643 patients hospitalized with cirrhosis from 2005 to 2014 were identified using the Nationwide Inpatient Sample database, of which 115,359 (2.4%) had SBP. We examined annual trends and used multivariable mixed-effects logistic regression analyses to obtain adjusted odds ratios by accounting for hospital level and patient level variables. RESULTS: We identified a striking increase in hospitalizations for SBP in cirrhotic patients (0.45% to 3.12%) and AKI in SBP patients (25.6% to 46.7%) from 2005 to 2014. Inpatient mortality decreased over the study period in patients with SBP (19.1% to 16.1%) and in patients with SBP plus AKI (40.9% to 27.6%). Patients with SBP had a higher inpatient mortality rate than those without SBP [15.5% vs. 6%, adjusted odd ratio (aOR): 2.02, P<0.001]. AKI was 2-fold more prevalent in cirrhotics with SBP than those without SBP (42.8% vs. 17.2%, aOR: 1.91, P<0.001) and concomitant AKI was associated with a 6-fold mortality increase (aOR: 5.84, P<0.001). Cirrhotic patients with SBP had higher hospitalization costs and longer length of stays than patients without SBP. CONCLUSIONS: Despite a higher hospitalization rate and prevalence of concomitant AKI, mortality in patients with SBP decreased during the study period. SBP is associated with high likelihood of development of AKI, which in turn, increases mortality.
GOALS: The purpose of our study was to evaluate trends of hospitalization, acute kidney injury (AKI) and mortality in cirrhoticpatients with spontaneous bacterial peritonitis (SBP). BACKGROUND: SBP is a frequent bacterial infection in cirrhoticpatients leading to increased morbidity and mortality. MATERIALS AND METHODS: A total of 4,840,643 patients hospitalized with cirrhosis from 2005 to 2014 were identified using the Nationwide Inpatient Sample database, of which 115,359 (2.4%) had SBP. We examined annual trends and used multivariable mixed-effects logistic regression analyses to obtain adjusted odds ratios by accounting for hospital level and patient level variables. RESULTS: We identified a striking increase in hospitalizations for SBP in cirrhoticpatients (0.45% to 3.12%) and AKI in SBP patients (25.6% to 46.7%) from 2005 to 2014. Inpatient mortality decreased over the study period in patients with SBP (19.1% to 16.1%) and in patients with SBP plus AKI (40.9% to 27.6%). Patients with SBP had a higher inpatient mortality rate than those without SBP [15.5% vs. 6%, adjusted odd ratio (aOR): 2.02, P<0.001]. AKI was 2-fold more prevalent in cirrhotics with SBP than those without SBP (42.8% vs. 17.2%, aOR: 1.91, P<0.001) and concomitant AKI was associated with a 6-fold mortality increase (aOR: 5.84, P<0.001). Cirrhoticpatients with SBP had higher hospitalization costs and longer length of stays than patients without SBP. CONCLUSIONS: Despite a higher hospitalization rate and prevalence of concomitant AKI, mortality in patients with SBP decreased during the study period. SBP is associated with high likelihood of development of AKI, which in turn, increases mortality.
Authors: Laura Iogna Prat; Peter Wilson; Suzanne C Freeman; Alex J Sutton; Nicola J Cooper; Davide Roccarina; Amine Benmassaoud; Maria Corina Plaz Torres; Neil Hawkins; Maxine Cowlin; Elisabeth Jane Milne; Douglas Thorburn; Chavdar S Pavlov; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2019-09-16
Authors: Oluyemi Komolafe; Danielle Roberts; Suzanne C Freeman; Peter Wilson; Alex J Sutton; Nicola J Cooper; Chavdar S Pavlov; Elisabeth Jane Milne; Neil Hawkins; Maxine Cowlin; Douglas Thorburn; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2020-01-16
Authors: Ahmed M El Gohary; Amany S Elyamany; Neveen L Mikhael; Mahmoud G Mahmoud; Marwa Mohamed Reda Tawfik Journal: Clin Exp Hepatol Date: 2021-05-14