IDDF2021-ABS-0019 An epidemiological meta-analysis on the worldwide prevalence, resistance and outcomes of spontaneous bacterial peritonitis in cirrhosis

Abstract

Meta-regression was conducted with mixed effects and logit transform on proportional data. Results 35 studies involving 18421 patients were included in the analysis.The OS (HR: 1.44, 95% CI: 1.14 -1.81, p<0.01), DFS (HR: 2.72, 95% CI: 2.18 -3.39, p<0.01) were significantly worse in LR compared to LT. There was no significant difference between regions. In a sensitivity analysis of uninodular tumours, there was no significant difference in OS (HR: 1.40, 0.91 -2.17, p=0.13) but significant in DFS (HR: 2.81, CI: 2.06 -3.83, p<0.01). Meta-regression found a significant increase in mortality between LR and LT in patients with Child-Pugh C cirrhosis on DFS (beta: 0.2254, 95% CI: 0.043-0.4064, p=0.0147) but there was no significant difference arising from different HCC aetiology. With enhance surveillance, there was no significant difference between LR and LT (HR: 1.15, 0.87 -1.51, p=0.32) but significantly different in DFS (HR: 1.70, 1.07 -2.67, p=0.02) Conclusions The results present an up-to-date analysis of literature in LT vs LR. Optimal surveillance strategy post-resection/transplant remains in contention. Our analysis found no significant difference between LT and LR in overall survival with enhancing surveillance. Regional and income levels differences also exist within the literature, although without significant difference between groups