Spontaneous bacterial peritonitis epidemiology and demographics
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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
Spontaneous bacterial peritonitis (SBP) is a potentially life threatening complication in patients with cirrhosis and has typically been described in hospitalized patients.The prevalence of SBP in cirrhotic patients with ascites admitted to the hospital ranges from 10%-30%.[1].Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated cirrhosis. 2 studies examining asymptomatic patients presenting for a therapeutic paracentesis showed a combined 2.5% incidence of spontaneous bacterial peritonitis.Overall one-year mortality rate after a first episode of SBP is 30%-93% regardless of its recurrence.The mean age of presentation of SBP was 49 years.In patients with ascites both sexes are affected equally.
Epidemiology and Demographics
Prevalence of SBP[2]
- 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.[3][4]
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.[5]
Age
- The maximum incidence of SBP was in age group of 41–50 years and the mean age of presentation was 49 years.[6]
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.[6]
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.[7] There is an increase in prevalence of spontaneous bacterial peritonitisin patients admitted to hospital.
References
- ↑ Oladimeji AA, Temi AP, Adekunle AE, Taiwo RH, Ayokunle DS (2013). "Prevalence of spontaneous bacterial peritonitis in liver cirrhosis with ascites". Pan Afr Med J. 15: 128. doi:10.11604/pamj.2013.15.128.2702. PMC 3830462. PMID 24255734.
- ↑ 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.
- ↑ 6.0 6.1 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.