![]() ![]() The model for end-stage liver disease (MELD) is a widely used prognostic score in patients with cirrhosis. Despite vast improvements in the early diagnosis and treatment of SBP, the short-term prognosis is poor in-hospital and 90-day mortality is 36% and 45% respectively. Presentation with SBP varies some patients are asymptomatic and are diagnosed incidentally during large-volume paracentesis whereas others present with severe sepsis and multiorgan failure. Due to impaired local and systemic immune defences, these microorganisms, most commonly Gram-negative enteric bacteria may not be killed effectively and therefore can colonise the ascitic fluid. SBP is common in patients with cirrhosis and ascites as a result of increased bacterial translocation from the gastrointestinal tract to mesenteric lymph nodes and other extra-intestinal sites. Spontaneous bacterial peritonitis (SBP) is defined as a bacterial infection of the ascitic fluid that occurs in the absence of any surgically treatable intra-abdominal sources of infection. Both scores consistently underestimated participants’ mortality, therefore future studies could evaluate the accuracy of alternative prognostic scores in this patient group. MELD-Na’s accuracy was higher but not significantly. For each MELD-Na tertile, these were: 25 (0-59.6), 5.2 (0.1-10.3) and 2.7 (0.1-8.1) for scores <17,17-26, ≥27 respectively.Ĭonclusion: In a small cohort of patients with cirrhosis and SBP, the MELD’s accuracy in predicting 90-day mortality was limited. Only concurrent hyponatremia (18.5 had significantly higher 90-day mortality than patients with MELD-Na ≤18.5 (88.9% (8/9) vs. Results: Of the 567 patients identified, 15 patients with cirrhosis and SBP were included. Receiver operator characteristic curves were compared, and standardised mortality ratios (SMRs) were calculated by comparing the number of deaths observed to the number predicted by MELD and MELD-Na. MELD and MELD-Na scores at diagnosis were calculated and associations with 90-day mortality were assessed using univariate analysis. Methods: Patients with cirrhosis and SBP were retrospectively identified from ascitic fluid samples sent for microscopy, culture and sensitivity analysis (1/1/18-31/12/20) and a previous audit. This study aimed to evaluate and compare the accuracy of MELD and MELD-Na for predicting 90-day mortality and determine whether the mortality risk estimates they provide accurately reflect the poor prognosis of patients with SBP Currently, the accuracy of the model for end-stage liver disease (MELD) and MELD-sodium (MELD-Na) as prognostic scores in this cohort is unclear. Background: Spontaneous bacterial peritonitis (SBP) is a common infection in patients with cirrhosis and ascites. ![]()
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