Spontaneous bacterial peritonitis epidemiology and demographics: Difference between revisions

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*Mortality is 20% even in treated SBP patients
*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.
*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.<ref name="pmid27563023">{{cite journal| author=Hung TH, Tsai CC, Hsieh YH, Tsai CC, Tseng CW, Tseng KC| title=The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan. | journal=Gut Liver | year= 2016 | volume= 10 | issue= 5 | pages= 803-7 | pmid=27563023 | doi=10.5009/gnl13468 | pmc=5003205 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27563023  }} </ref>


===Age===
===Age===

Revision as of 20:02, 22 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

  1. 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.
  2. 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.
  3. 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.
  4. 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. 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.
  6. Runyon BA (1988). "Spontaneous bacterial peritonitis: an explosion of information". Hepatology. 8 (1): 171–5. doi:10.1002/hep.1840080131. PMID 3338704.

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