Spontaneous bacterial peritonitis epidemiology and demographics: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
=== Prevalence of SBP<ref name="pmid26962397">{{cite journal| author=Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D| title=Bacterial infections in cirrhosis: A critical review and practical guidance. | journal=World J Hepatol | year= 2016 | volume= 8 | issue= 6 | pages= 307-21 | pmid=26962397 | doi=10.4254/wjh.v8.i6.307 | pmc=4766259 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26962397 }} </ref> | === Prevalence === | ||
*The prevalence of SBP in cirrhotic patients with ascites admitted to the hospital ranges from 10%-30%. <ref name="pmid26962397">{{cite journal| author=Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D| title=Bacterial infections in cirrhosis: A critical review and practical guidance. | journal=World J Hepatol | year= 2016 | volume= 8 | issue= 6 | pages= 307-21 | pmid=26962397 | doi=10.4254/wjh.v8.i6.307 | pmc=4766259 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26962397 }} </ref> | |||
*About 50% of cases are present at the time of hospitalization and 50% develop during the hospitalization. | *About 50% of cases are present at the time of hospitalization and 50% develop during the hospitalization. | ||
===Incidence | ===Incidence === | ||
====In hospitalized patients==== | ====In hospitalized patients==== | ||
*Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated [[cirrhosis]]. | *Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated [[cirrhosis]]. | ||
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*2 studies examining asymptomatic patients presenting for a therapeutic [[paracentesis]] showed a combined 2.5% incidence of spontaneous bacterial peritonitis (defined as absolute neutrophil count >250 cells/mm3) in 545 patients.<ref name="Evans2003">{{cite journal|last1=Evans|first1=L|title=Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites|journal=Hepatology|volume=37|issue=4|year=2003|pages=897–901|issn=02709139|doi=10.1053/jhep.2003.50119}}</ref><ref name="ChinnockAfarian2008">{{cite journal|last1=Chinnock|first1=Brian|last2=Afarian|first2=Hagop|last3=Minnigan|first3=Hal|last4=Butler|first4=Jack|last5=Hendey|first5=Gregory W.|title=Physician Clinical Impression Does Not Rule Out Spontaneous Bacterial Peritonitis in Patients Undergoing Emergency Department Paracentesis|journal=Annals of Emergency Medicine|volume=52|issue=3|year=2008|pages=268–273|issn=01960644|doi=10.1016/j.annemergmed.2008.02.016}}</ref> | *2 studies examining asymptomatic patients presenting for a therapeutic [[paracentesis]] showed a combined 2.5% incidence of spontaneous bacterial peritonitis (defined as absolute neutrophil count >250 cells/mm3) in 545 patients.<ref name="Evans2003">{{cite journal|last1=Evans|first1=L|title=Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites|journal=Hepatology|volume=37|issue=4|year=2003|pages=897–901|issn=02709139|doi=10.1053/jhep.2003.50119}}</ref><ref name="ChinnockAfarian2008">{{cite journal|last1=Chinnock|first1=Brian|last2=Afarian|first2=Hagop|last3=Minnigan|first3=Hal|last4=Butler|first4=Jack|last5=Hendey|first5=Gregory W.|title=Physician Clinical Impression Does Not Rule Out Spontaneous Bacterial Peritonitis in Patients Undergoing Emergency Department Paracentesis|journal=Annals of Emergency Medicine|volume=52|issue=3|year=2008|pages=268–273|issn=01960644|doi=10.1016/j.annemergmed.2008.02.016}}</ref> | ||
=== Mortality rate | === Mortality rate === | ||
*The in-hospital mortality for SBP ranges from 10%-50% depending on | *The in-hospital mortality for SBP ranges from 10%-50% depending on many factors. | ||
*Mortality is 20% even in treated SBP patients | *Mortality is 20% even in treated SBP patients. | ||
*Overall one-year mortality rate after a first episode of SBP is 30%-93% regardless of its recurrence. | *Overall one-year mortality rate after a first episode of SBP is 30%-93% regardless of its recurrence. | ||
* The effect of SBP on the mortality of cirrhotic patients with ascites | * The effect of SBP on the mortality of cirrhotic patients with ascites is low in those surviving more than 90 days after the first SBP event.<ref name="pmid27563023">{{cite journal| author=Hung TH, Tsai CC, Hsieh YH, Tsai CC, Tseng CW, Tseng KC| title=The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan. | journal=Gut Liver | year= 2016 | volume= 10 | issue= 5 | pages= 803-7 | pmid=27563023 | doi=10.5009/gnl13468 | pmc=5003205 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27563023 }} </ref> | ||
===Age=== | ===Age=== | ||
* | *SBP is common in age group of 41–50 years and the mean age of presentation was 49 years.<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of [[Cirrhosis]] with [[Ascites]]. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | ||
===Gender=== | ===Gender=== | ||
*In patients with ascites both sexes are affected equally. Male are more commonly affected with SBP probably due to increased alcohol intake leading to [[cirrhosis]].<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | *In patients with ascites both sexes are affected equally. Male are more commonly affected with SBP probably due to increased alcohol intake leading to [[cirrhosis]].<ref name="pmid26393155">{{cite journal| author=Paul K, Kaur J, Kazal HL| title=To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis with Ascites. | journal=J Clin Diagn Res | year= 2015 | volume= 9 | issue= 7 | pages= OC09-12 | pmid=26393155 | doi=10.7860/JCDR/2015/14855.6191 | pmc=4572986 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26393155 }} </ref> | ||
In patients with [[ascites]] who underwent routine [[paracentesis]], the [[incidence]] of active [[spontaneous bacterial peritonitis]] ranged from 10% to 27% at the time of hospital admission.<ref name="pmid3338704">{{cite journal | author = Runyon BA | title = Spontaneous bacterial peritonitis: an explosion of information | journal = Hepatology | volume = 8 | issue = 1 | pages = 171–5 | year = 1988 | pmid = 3338704 | doi = 10.1002/hep.1840080131| url = | issn = }}</ref> There is an increase in [[prevalence]] of [[spontaneous bacterial peritonitis]]in patients admitted to hospital. | |||
* In patients with [[ascites]] who underwent routine [[paracentesis]], the [[incidence]] of active [[spontaneous bacterial peritonitis]] ranged from 10% to 27% at the time of hospital admission.<ref name="pmid3338704">{{cite journal | author = Runyon BA | title = Spontaneous bacterial peritonitis: an explosion of information | journal = Hepatology | volume = 8 | issue = 1 | pages = 171–5 | year = 1988 | pmid = 3338704 | doi = 10.1002/hep.1840080131| url = | issn = }}</ref> There is an increase in [[prevalence]] of [[spontaneous bacterial peritonitis]]in patients admitted to hospital. | |||
==References== | ==References== | ||
Revision as of 15:47, 8 February 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Shivani Chaparala M.B.B.S [3]
Overview
Spontaneous bacterial peritonitis (SBP) is a potentially life threatening complication in patients with cirrhosis and has typically been described in hospitalized patients.The prevalence of SBP in cirrhotic patients with ascites admitted to the hospital ranges from 10%-30%.[1].Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated cirrhosis. 2 studies examining asymptomatic patients presenting for a therapeutic paracentesis showed a combined 2.5% incidence of spontaneous bacterial peritonitis.Overall one-year mortality rate after a first episode of SBP is 30%-93% regardless of its recurrence.The mean age of presentation of SBP was 49 years.In patients with ascites both sexes are affected equally.
Epidemiology and Demographics
Prevalence
- The prevalence of SBP in cirrhotic patients with ascites admitted to the hospital ranges from 10%-30%. [2]
- About 50% of cases are present at the time of hospitalization and 50% develop during the hospitalization.
Incidence
In hospitalized patients
- Studies have demonstrated a 12% incidence of spontaneous bacterial peritonitis in patients admitted with decompensated cirrhosis.
In outpatient clinic ED setting
- 2 studies examining asymptomatic patients presenting for a therapeutic paracentesis showed a combined 2.5% incidence of spontaneous bacterial peritonitis (defined as absolute neutrophil count >250 cells/mm3) in 545 patients.[3][4]
Mortality rate
- The in-hospital mortality for SBP ranges from 10%-50% depending on many factors.
- Mortality is 20% even in treated SBP patients.
- Overall one-year mortality rate after a first episode of SBP is 30%-93% regardless of its recurrence.
- The effect of SBP on the mortality of cirrhotic patients with ascites is low in those surviving more than 90 days after the first SBP event.[5]
Age
- SBP is common in age group of 41–50 years and the mean age of presentation was 49 years.[6]
Gender
- In patients with ascites both sexes are affected equally. Male are more commonly affected with SBP probably due to increased alcohol intake leading to cirrhosis.[6]
- In patients with ascites who underwent routine paracentesis, the incidence of active spontaneous bacterial peritonitis ranged from 10% to 27% at the time of hospital admission.[7] There is an increase in prevalence of spontaneous bacterial peritonitisin patients admitted to hospital.
References
- ↑ Oladimeji AA, Temi AP, Adekunle AE, Taiwo RH, Ayokunle DS (2013). "Prevalence of spontaneous bacterial peritonitis in liver cirrhosis with ascites". Pan Afr Med J. 15: 128. doi:10.11604/pamj.2013.15.128.2702. PMC 3830462. PMID 24255734.
- ↑ Bunchorntavakul C, Chamroonkul N, Chavalitdhamrong D (2016). "Bacterial infections in cirrhosis: A critical review and practical guidance". World J Hepatol. 8 (6): 307–21. doi:10.4254/wjh.v8.i6.307. PMC 4766259. PMID 26962397.
- ↑ Evans, L (2003). "Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites". Hepatology. 37 (4): 897–901. doi:10.1053/jhep.2003.50119. ISSN 0270-9139.
- ↑ Chinnock, Brian; Afarian, Hagop; Minnigan, Hal; Butler, Jack; Hendey, Gregory W. (2008). "Physician Clinical Impression Does Not Rule Out Spontaneous Bacterial Peritonitis in Patients Undergoing Emergency Department Paracentesis". Annals of Emergency Medicine. 52 (3): 268–273. doi:10.1016/j.annemergmed.2008.02.016. ISSN 0196-0644.
- ↑ Hung TH, Tsai CC, Hsieh YH, Tsai CC, Tseng CW, Tseng KC (2016). "The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan". Gut Liver. 10 (5): 803–7. doi:10.5009/gnl13468. PMC 5003205. PMID 27563023.
- ↑ 6.0 6.1 Paul K, Kaur J, Kazal HL (2015). "To Study the Incidence, Predictive Factors and Clinical Outcome of Spontaneous Bacterial Peritonitis in Patients of [[Cirrhosis]] with [[Ascites]]". J Clin Diagn Res. 9 (7): OC09–12. doi:10.7860/JCDR/2015/14855.6191. PMC 4572986. PMID 26393155. URL–wikilink conflict (help)
- ↑ Runyon BA (1988). "Spontaneous bacterial peritonitis: an explosion of information". Hepatology. 8 (1): 171–5. doi:10.1002/hep.1840080131. PMID 3338704.