Clinical Characteristics and Mortality in Patients with Spontaneous Bacterial Peritonitis: A Retrospective Cohort Study

作者：J Zottl, C Derfler, K Shehi, M Schwarz, F Koutny, A Maieron, J Prosenz · 发表于：Zeitschrift für Gastroenterologie · 年份：2026 · DOI：10.1055/s-0046-1823064 · 研究领域：Dialysis and Renal Disease Management、Appendicitis Diagnosis and Management、Amoebic Infections and Treatments

Introduction Spontaneous bacterial peritonitis (SBP) remains a severe complication in cirrhosis, yet risk factors are not fully defined. Material and Methods Patients undergoing paracentesis between January 2018 and December 2021 were retrospectively analyzed. SBP was defined as a polymorphonuclear (PMN) cell count of≥250cells/mm³ in ascites. Results In total, 209 patients were included (median age 63 [56-71] years, 21.1% female). Median Child-Pugh-Score(CPS) was 10 [8-11] and MELD 3.0 was 18 [13-23]. Etiologies were mainly ALD 60.8%, MASLD 21.5%, and cryptogenic 5.3%. Thirty-five (16.7%) patients had SBP and 174 (83.3%) had ascites without SBP. SBP patients were older (68.1 [71.5-62.0] vs. 61.5 [71-56] years,p=0.023) and had higher MELD (22 [27-16] vs. 17 [13-22],p=0.004) scores. Also, cirrhosis etiology differed (p=0.001) with higher MASLD (31.4% vs 19.5%) and AIH (14.3% vs 2.3%) and lower ALD (40% vs 64.9%) in SBP. In multivariable analysis, higher MELD was associated with SBP (OR 1.11,95%CI 1.04-1.18,p=0.001). However, among individual components, only creatinine (OR 2.09,95%CI 1.18-3.7,p=0.01) and sodium (OR 0.93,95%CI 0.86–1.00,p=0.044) were independently associated with occurrence of SBP, while albumin (OR 0.99,95%CI 0.91–1.09,p=0.90) and bilirubin (OR 1.00,95%CI 0.92–1.06,p=0.90) were not. Higher CRP (OR 1.31,95%CI 1.17–1.48,p<0.001) and lower platelet count (OR 0.99,95%CI 0.98–1.00,p=0.002) were independently associated with SBP. Kaplan–Meier survival was numerically...