LC : Renal Function Predicts 14 Days Mortality in Cirrhotic Patient with Spontaneous Bacterial Peritonitis; Multicenter Retrospective Study = LC : Renal Function Predicts 14 Days Mortality in Cirrhotic Patient with Spontaneous Bacterial Peritonitis; Multicenter Retrospective Study

다국어 초록 (Multilingual Abstract)

Background: Spontaneous bacterial peritonitis (SBP) is one of severe complications in liver cirrhosis. Early detection of high-risk patients is essential for prognostic improvement. We investigate the predictive factors related with 14 days mortality in patient with SBP. Methods: We conducted a retrospective study of two hundred seventy five SBP patients admitted in four tertiary referral hospitals between August 2002 and February 2013. We collect patients` laboratory and radiologic data from medical record. We calculated Child-Turcotte-Pugh score (CTP), Model for End- Stage Liver Disease-Na (MELD-Na) score using the laboratory data at the time of SBP occurrence. Results: The mean age of the patients was 56.9 years (213 male, 62 female). The cause of liver cirrhosis was hepatitis B (44%), alcohol (41.8%) and hepatitis C (6.9%). Mean score of MELD-Na and CTP score were 27.44 and 10.67, respectively. The patients who die from SBP within 14 days were 17.8% (n=49). The statistically significant factor of multivariate analysis were baseline MELD-Na (P=0.002) and GFR (P=0.034). Two hundred thirty three patients who could follow-up were analyzed. Baseline MELD-Na (P=0.027) and maximal creatinine level during the follow-up (P=0.02) were significantly associated with 14 days mortality. The prognostic accuracy of baseline MELD-Na, initial GFR and maximal creatinine during the follow-up were 75.6%, 74.0% and 78.0%, respectively (P<0.001). The cut-off values were 27 (baseline MELD-Na), 35.9 mL/min (initial GFR) and 2 mg/dL (maximal creatinine), respectively (P<0.001). Conclusions: Renal function was important predictive factor of 14 days mortality in cirrhotic patients with SBP. The patients with SBP and renal insufficiency should be treated more intensively.