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Spontaneous bacterial peritonitis (SBP) is often seen in patients with liver cirrhosis. Chronic alcoholic liver disease (CALD), alcoholic hepatitis, hepatitis B, hepatitis C, hemochromatosis, and autoimmune hepatitis are known to result in liver cirrhosis. There seems to be a link between in-hospital mortality in SBP and CALD.
A recent study by Bhandari and colleagues evaluated the risk of in-hospital mortality on account of CALD and other comorbidities in SBP inpatients. This cross-sectional study used the Nationwide Inpatient Sample (NIS, 2012 to 2014) from the United States with 6,530 patients 18-50 years of age having a primary diagnosis of SBP. Odds ratio (OR) were assessed for in-hospital mortality in SBP by comorbidities.
CALD prevalence in SBP patients was estimated as 43.6%. A higher proportion were males (68.8%) and whites (67%). The odds of in-hospital mortality in SBP patients were higher in middle-aged adults (OR 2.8, 95% CI 1.74-4.45). Race and sex non-significantly predicted mortality risk. Increased mortality was noted in patients with comorbid coagulopathy (OR 1.9, 95% CI 1.45-2.48) and heart failure (OR 3.9, 95% CI 2.46-6.36). Controlling for confounders, CALD had a significant link with increased in-hospital mortality (OR 1.5, 95% CI 1.12-1.94) in SBP inpatients.
CALD was thus found to independently increase the risk of in-hospital mortality in SBP patients by 48%. It seems prudent to introduce alcohol use screening, alcohol abstinence and supportive therapy at an early stage in order to improve health-related quality of life and decrease in-hospital mortality in SBP patients.
Source: Bhandari R, Khaliq K, Ravat V, et al. Chronic Alcoholic Liver Disease and Mortality Risk in Spontaneous Bacterial Peritonitis: Analysis of 6,530 Hospitalizations. Cureus. 2020 May 18;12(5):e8189.