Model for End-Stage Liver Disease Score Predicts Development of First Episode of Spontaneous Bacterial Peritonitis in Patients With Cirrhosis.
Academic Medical Centers
Aged
Anti-Bacterial Agents
/ therapeutic use
Bacterial Infections
/ complications
Case-Control Studies
Disease Progression
Female
Follow-Up Studies
Hospital Mortality
Humans
Linear Models
Liver Cirrhosis
/ complications
Liver Failure
/ complications
Male
Middle Aged
Peritonitis
/ complications
Predictive Value of Tests
Reference Values
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Analysis
Time Factors
Treatment Outcome
Journal
Mayo Clinic proceedings
ISSN: 1942-5546
Titre abrégé: Mayo Clin Proc
Pays: England
ID NLM: 0405543
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
30
10
2018
revised:
13
02
2019
accepted:
19
02
2019
pubmed:
12
8
2019
medline:
14
1
2020
entrez:
12
8
2019
Statut:
ppublish
Résumé
To examine whether baseline model for end-stage liver disease (MELD) score in patients with cirrhosis and ascites predicts the future development of first spontaneous bacterial peritonitis (SBP) episode. A retrospective case-control study was performed at three academic centers to select patients admitted with first SBP episode (cases) and those with ascites admitted for decompensation without SBP (controls). Medical records from these centers were reviewed between January 1, 2008, and December 31, 2013. Cases and controls were matched (1:2) for age, sex, and race. Conditional logistic recession models were built to determine whether baseline MELD score (within a month before hospitalization) predicts first SBP episode. Of 697 patients (308, 230, and 159 from centers A, B, and C, respectively), cases and controls were matched in 94%, 89%, and 100% at three respective centers. In the pooled sample, probability of SBP was 11%, 31%, 71%, and 93% at baseline MELD scores less than or equal to 10, from 11 to 20, from 21 to 30, and greater than 30, respectively. Compared with MELD score less than or equal to 10, patients with MELD scores from 11 to 20, 21 to 30, and greater than 30 had six- (3- to 11-), 29- (12- to 69-), and 115- (22- to 598-) folds (95% CI) risk of SBP, respectively. Based on different MELD score cutoff points, MELD score greater than 17 was most accurate in predicting SBP occurrence. Analyzing 315 patients (152 cases) with available data on ascitic fluid protein level controlling for age, sex, and center, MELD score but not ascitic fluid protein associated with first SBP episode with respective odds ratios of 1.20 (1.14 to 1.26) and 0.88 (0.70 to 1.11). Baseline MELD score predicts first SBP episode in patients with cirrhosis and ascites.
Identifiants
pubmed: 31400909
pii: S0025-6196(19)30347-7
doi: 10.1016/j.mayocp.2019.02.027
pmc: PMC9709904
mid: NIHMS1849804
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1799-1806Subventions
Organisme : AHRQ HHS
ID : T32 HS013852
Pays : United States
Informations de copyright
Copyright © 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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