Predictors of fifty days in-hospital mortality in decompensated cirrhosis patients with spontaneous bacterial peritonitis

Table 1 Baseline characteristics of the hospitalized patients with spontaneous bacterial peritonitis in decompensated cirrhosis

Variables	Overall (n = 218)	Survivors (n = 124)	Deaths (n = 94)	P value
Demographic data
Age (yr) mean ± SD	49.90 ± 12.52	49.86 ± 13.37	49.96 ± 11.37	0.950
Male (%)	177 (81.19)	99 (79.84)	78 (82.98)	0.557
Etiology of cirrhosis (%)
Ethanol	100 (45.87)	48 (38.71)	52 (55.32)	0.689
Crypto/NAFLD	63 (28.90)	38 (30.65)	25 (26.60)	0.104
HCV	23 (10.55)	16 (12.905)	7 (7.45)	0.068
Clinical data (%)
Hepatocellular carcinoma	17 (7.80)	9 (7.26)	8 (8.51)	0.733
Diabetes	47 (21.56)	27 (21.77)	20 (21.28)	0.929
Acute kidney injury	99 (45.41)	35 (28.23)	64 (68.09)	< 0.001
Respiratory failure	10 (4.59)	6 (4.84)	4 (4.26)	0.978
Hepatic encephalopathy	109 (50.0)	50 (40.32)	59 (62.77)	0.001
Septic shock	28 (12.84)	4 (3.23)	24 (25.53)	< 0.001
Positive culture	48 (22.02)	21 (16.94)	27 (28.72)	0.038
Laboratory data1 (mean ± SD)
Ascitic neutrophil count (cells/mm3)	3346.07 ± 4700.60	3899.28 ± 5003.75	2616.30 ± 4182.81	0.040
Hemoglobin (g/dL)	9.42 ± 1.88	9.58 ± 1.77	9.21 ± 2.01	0.154
Platelet count (mmol/L)	128.24 ± 102.11	138.43 ± 111.25	115.03 ± 87.69	0.095
Leucocyte count (103/μL)	13.30 ± 9.35	11.86 ± 8.65	15.17 ± 9.92	0.009
Sodium (mEq/L)	132.14 ± 7.69	132.50 ± 6.54	131.67 ± 9.01	0.454
Billirubin (mg/dL)	8.17 ± 8.81	5.85 ± 6.27	11.24 ± 10.61	< 0.001
Albumin (g/dL)	2.32 ± 0.50	2.35 ± 0.48	2.28 ± 0.52	0.250
INR	2.31 ± 1.11	2.09 ± 1.08	2.59 ± 1.08	0.001
AST (U/L)	59.66 ± 109.81	79.23 ± 98.71	171.3 ± 321.94	0.003
ALT (U/L)	59.66 ± 109.81	46.49 ± 72.93	77.04 ± 143.41	0.041
Urea (mg/dL)	70.31 ± 52.42	62.24 ± 48.23	80.94 ± 55.98	0.008
Creatinine (mg/dL)	1.67 ± 1.29	1.58 ± 1.39	1.80 ± 1.15	0.217
Scores (mean ± SD)
CTP (B/C)	10.72 ± 1.82	10.50 ± 1.95	11.02 ± 1.60	0.034
MELD	24.79 ± 8.28	22.20 ± 7.59	28.20 ± 7.94	< 0.001
MELD-Na	27.53 ± 7.57	25.21 ± 7.44	30.59 ± 6.62	< 0.001

¹Results obtained on the day of diagnosis of spontaneous bacterial peritonitis. MELD-Na: Model for end-stage liver disease-sodium; MELD: Model for end-stage liver disease; HCV: Hepatitis C virus; NAFLD: Non-alcoholic fatty liver disease; INR: International normalized ratio; AST: Aspartate aminotransferase; ALT: Alanineaminotransferase; CTP: Child-Turcotte-Pugh.

Table 2 Cox proportional regression analysis of risk factors for spontaneous bacterial peritonitis related in-hospital related mortality

Variables	1HR (95%CI)	P value
AKI	2.16 (1.36-3.42)	0.001
Septic shock	1.73 (1.05-2.83)	0.029
MELD-Na	1.06 (1.02-1.09)	< 0.001

¹Hazard ratio (HR) adjusted for age and gender. AKI: Acute kidney injury; MELD-Na: Model for end-stage liver disease-sodium.

Table 3 Diagnostic accuracy of prognostic variables to predict spontaneous bacterial peritonitis related in-hospital mortality

Predictors	Sensitivity	Specificity	PPV	NPV	+LR	-LR
AKI	64.6	74.8	68.1	71.8	2.56	0.47
Septic shock	85.7	63.2	25.5	96.8	2.33	0.23
MELD-Na(28)1	92.9	60.3	24.5	97.9	2.34	0.12

¹Cut off score for MELD-Na. PPV: Positive predictive value; NPV: Negative predictive value; +LR: Positive likelihood ratio; -LR: Negative likelihood ratio; AKI: Acute kidney injury; MELD-Na: Model for end stage liver disease-sodium.