MELD Score Is Not Related to Spontaneous Bacterial Peritonitis

Abstract

This study investigates the correlation between SBP and repeated paracentesis, and its relation to MELD score, in cirrhotic patients with refractory ascites in an outpatient setting. Through the data base, 148 cirrhotic patients were prospectively included in the study with refractory ascites undergoing relief paracentesis from March 2012 to March 2013. Demographics data, etiology of liver disease, MELD score, and inscription on the waiting list for liver transplantation were analyzed. The ascites removed was analyzed through cellular count and culture for the diagnosis of spontaneous bacterial peritonitis. The cirrhotic patients underwent a total of 854 paracentesis procedures in the ambulatory setting during the study period. Eighty-one patients (54%) were on the waiting list for liver transplantation. Patients on the liver transplant list had higher associated costs due to a higher total number of outpatient paracentesis procedures (394.7 ± 512.3 versus 291.7 ± 384.7) and a higher volume drained per procedure (6.5 ± 8.5 versus 4.8 ± 6.4). There were 28 episodes of SBP (3.3%) diagnosed in 24 patients. In conclusion, the prevalence of asymptomatic SBP in cirrhotic patients with refractory ascites undergoing repeated paracentesis is low. MELD score is not related to spontaneous bacterial peritonitis.

The Palliative Management of Refractory Cirrhotic Ascites Using the PleurX©Catheter

“…The lack of relationship between severity of liver disease and SBP has been previously reported in the literature. Haddad et al performed a prospective study evaluating the rate of SBP in 148 patients undergoing serial LVP; following 854 paracentesis procedures, MELD was not associated with the development of SBP [ 28 ].…”

Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review

“…Factors associated with the incidence of SBP in patients with LC and ascites include age, history of SBP[ 100 ], gastrointestinal bleeding[ 61 , 100 ], and endoscopic intervention for varix control[ 101 ]. Severity of liver dysfunction[ 42 , 54 , 56 , 61 , 102 ] including the Child-Pugh score or model for end-stage liver disease (MELD) score has been reported as a predictive factor, but few studies have not found an association of MELD score and the incidence of SBP[ 103 ] in patients with LC and refractory ascites. The MELD score does not include some clinical variables that are evaluated in the Child-Pugh score[ 104 , 105 ].…”

“…SBP mortality has decreased in the four decades since it was first described as a result of early diagnosis and prompt treatment[ 56 ] and treatment by liver transplantation[ 103 ]. Hospital mortality is estimated as 10%-50% for the first episode and 31%-93% for the second or subsequent episodes[ 53 , 118 ].…”

Multivariate predictive model for asymptomatic spontaneous bacterial peritonitis in patients with liver cirrhosis

“…However, some studies may hold different opinions. In the study by Haddad et al[ 26 ], MELD was confirmed to have no association with SBP. Although MELD had no direct association with SBP, MELD might be employed as a predictive biomarker for SBP.…”