Spontaneous bacterial peritonitis epidemiology and demographics: Difference between revisions
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===Incidence of SBP=== | ===Incidence of SBP=== | ||
====In hospitalized patients==== | ====In hospitalized patients==== | ||
*Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated cirrhosis. | *Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated [[cirrhosis]]. | ||
====In outpatient clinic ED setting==== | ====In outpatient clinic ED setting==== | ||
*2 studies examining asymptomatic patients presenting for a therapeutic paracentesis showed a combined 2.5% incidence of spontaneous bacterial peritonitis (defined as absolute neutrophil count >250 cells/mm3) in 545 patients.<ref name="Evans2003">{{cite journal|last1=Evans|first1=L|title=Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites|journal=Hepatology|volume=37|issue=4|year=2003|pages=897–901|issn=02709139|doi=10.1053/jhep.2003.50119}}</ref><ref name="ChinnockAfarian2008">{{cite journal|last1=Chinnock|first1=Brian|last2=Afarian|first2=Hagop|last3=Minnigan|first3=Hal|last4=Butler|first4=Jack|last5=Hendey|first5=Gregory W.|title=Physician Clinical Impression Does Not Rule Out Spontaneous Bacterial Peritonitis in Patients Undergoing Emergency Department Paracentesis|journal=Annals of Emergency Medicine|volume=52|issue=3|year=2008|pages=268–273|issn=01960644|doi=10.1016/j.annemergmed.2008.02.016}}</ref> | *2 studies examining asymptomatic patients presenting for a therapeutic [[paracentesis]] showed a combined 2.5% incidence of spontaneous bacterial peritonitis (defined as absolute neutrophil count >250 cells/mm3) in 545 patients.<ref name="Evans2003">{{cite journal|last1=Evans|first1=L|title=Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites|journal=Hepatology|volume=37|issue=4|year=2003|pages=897–901|issn=02709139|doi=10.1053/jhep.2003.50119}}</ref><ref name="ChinnockAfarian2008">{{cite journal|last1=Chinnock|first1=Brian|last2=Afarian|first2=Hagop|last3=Minnigan|first3=Hal|last4=Butler|first4=Jack|last5=Hendey|first5=Gregory W.|title=Physician Clinical Impression Does Not Rule Out Spontaneous Bacterial Peritonitis in Patients Undergoing Emergency Department Paracentesis|journal=Annals of Emergency Medicine|volume=52|issue=3|year=2008|pages=268–273|issn=01960644|doi=10.1016/j.annemergmed.2008.02.016}}</ref> | ||
=== Mortality rate of SBP === | === Mortality rate of SBP === | ||
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===Age=== | ===Age=== | ||
*The maximum incidence of SBP was in age group of 41–50 years and the mean age of presentation was 49 years.<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | *The maximum incidence of SBP was in age group of 41–50 years and the mean age of presentation was 49 years.<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of [[Cirrhosis]] with [[Ascites]]. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | ||
===Gender=== | ===Gender=== | ||
*In patients with ascites both sexes are affected equally. Male are more commonly affected with SBP probably due to increased alcohol intake leading to cirrhosis.<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | *In patients with ascites both sexes are affected equally. Male are more commonly affected with SBP probably due to increased alcohol intake leading to [[cirrhosis]].<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | ||
In patients with [[ascites]] who underwent routine [[paracentesis]], the [[incidence]] of active [[spontaneous bacterial peritonitis]] ranged from 10% to 27% at the time of hospital admission.<ref name="pmid3338704">{{cite journal | author = Runyon BA | title = Spontaneous bacterial peritonitis: an explosion of information | journal = Hepatology | volume = 8 | issue = 1 | pages = 171–5 | year = 1988 | pmid = 3338704 | doi = 10.1002/hep.1840080131| url = | issn = }}</ref> There is an increase in [[prevalence]] of [[spontaneous bacterial peritonitis]]in patients admitted to hospital. | In patients with [[ascites]] who underwent routine [[paracentesis]], the [[incidence]] of active [[spontaneous bacterial peritonitis]] ranged from 10% to 27% at the time of hospital admission.<ref name="pmid3338704">{{cite journal | author = Runyon BA | title = Spontaneous bacterial peritonitis: an explosion of information | journal = Hepatology | volume = 8 | issue = 1 | pages = 171–5 | year = 1988 | pmid = 3338704 | doi = 10.1002/hep.1840080131| url = | issn = }}</ref> There is an increase in [[prevalence]] of [[spontaneous bacterial peritonitis]]in patients admitted to hospital. | ||
Revision as of 15:52, 23 January 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Shivani Chaparala M.B.B.S [3]
Overview
Epidemiology and Demographics
Prevalence of SBP[1]
- The prevalence of SBP in cirrhotic patients with ascites admitted to the hospital ranges from 10%-30%.
- About 50% of cases are present at the time of hospitalization and 50% develop during the hospitalization.
Incidence of SBP
In hospitalized patients
- Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated cirrhosis.
In outpatient clinic ED setting
- 2 studies examining asymptomatic patients presenting for a therapeutic paracentesis showed a combined 2.5% incidence of spontaneous bacterial peritonitis (defined as absolute neutrophil count >250 cells/mm3) in 545 patients.[2][3]
Mortality rate of SBP
- The in-hospital mortality for SBP ranges from 10%-50% depending on various factors.
- Mortality is 20% even in treated SBP patients
- Overall one-year mortality rate after a first episode of SBP is 30%-93% regardless of its recurrence.
- The effect of SBP on the mortality of cirrhotic patients with ascites disappeared in those surviving more than 90 days after the first SBP event.[4]
Age
- The maximum incidence of SBP was in age group of 41–50 years and the mean age of presentation was 49 years.[5]
Gender
- In patients with ascites both sexes are affected equally. Male are more commonly affected with SBP probably due to increased alcohol intake leading to cirrhosis.[5]
In patients with ascites who underwent routine paracentesis, the incidence of active spontaneous bacterial peritonitis ranged from 10% to 27% at the time of hospital admission.[6] There is an increase in prevalence of spontaneous bacterial peritonitisin patients admitted to hospital.
References
- ↑ Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D (2016). "Bacterial infections in cirrhosis: A critical review and practical guidance". World J Hepatol. 8 (6): 307–21. doi:10.4254/wjh.v8.i6.307. PMC 4766259. PMID 26962397.
- ↑ Evans, L (2003). "Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites". Hepatology. 37 (4): 897–901. doi:10.1053/jhep.2003.50119. ISSN 0270-9139.
- ↑ Chinnock, Brian; Afarian, Hagop; Minnigan, Hal; Butler, Jack; Hendey, Gregory W. (2008). "Physician Clinical Impression Does Not Rule Out Spontaneous Bacterial Peritonitis in Patients Undergoing Emergency Department Paracentesis". Annals of Emergency Medicine. 52 (3): 268–273. doi:10.1016/j.annemergmed.2008.02.016. ISSN 0196-0644.
- ↑ Hung TH, Tsai CC, Hsieh YH, Tsai CC, Tseng CW, Tseng KC (2016). "The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan". Gut Liver. 10 (5): 803–7. doi:10.5009/gnl13468. PMC 5003205. PMID 27563023.
- ↑ 5.0 5.1 Paul K, Kaur J, Kazal HL (2015). "To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of [[Cirrhosis]] with [[Ascites]]". J Clin Diagn Res. 9 (7): OC09–12. doi:10.7860/JCDR/2015/14855.6191. PMC 4572986. PMID 26393155. URL–wikilink conflict (help)
- ↑ Runyon BA (1988). "Spontaneous bacterial peritonitis: an explosion of information". Hepatology. 8 (1): 171–5. doi:10.1002/hep.1840080131. PMID 3338704.