Spontaneous Bacterial Peritonitis in Alcoholic Cirrhosis

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is one of the most common complications in cirrhosis with ascites, which is associated with a high mortality. Various studies have shown that the prevalence of PBS ranges from 20-30% in patients with cirrhosis and ascites. Not in all cases it is accompanied by obvious symptoms, which makes early diagnosis difficult. Aim: The aims of this study were to assess the prevalence and the risk factors of PBS in alcohoolic liver cirrhosis. Methodology: This is a retrospective study, which considers all cases diagnosed with PBS admitted to our hospital during 2018-2021. Diagnosis is based on the European Association for the Study of Liver (EASL) guidelines. The patients were divided into two groups, alcohoolic cirrhosis with PBS, and without PBS. Data collection consists of filling out a standard form for each patient,which contained information about the diagnosis, the degree of liver function damage evaluated by Child-Pough score and MELD score, clinical and laboratory indicators and complications associated with cirrhosis with PBS, ascitic fluid analyses. All categorical variables were analised by using SPSS version 25, and t-test were used for continuous date. Results: The average age of the patients included in the study was 54.15 ± 12.5 years, while according to gender, there were 112 males (97.3%) and 3 females (2.7%). According to the evaluation of MELD, it was seen to be higher in the group with PBS than those without PBS (p < 0.05). The most frequent complications accompanying PBS were Encephalopathy (p < 0.004), hepatorenal syndrome (p < 0.004), gastro\intestinal hemorrhage (p < 0.004). From laboratory data, platelets (p < 0.015), creatinine (p < 0.006), bilirubin (p < 0.002), INR (p < 0.049) and prothrombin level (p < 0.002) were seen as predictive factors. Conclusions: The most probable predictive factors in the case of PBS in alcoholic cirrhosis were found the low level of platelets, prolonged level of INR and prothrombin, increased level of creatinine. While the most frequent associated complications were hepatic encephalopathy, HRS, G\I hemorrhage, jaundice.