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Spontaneous bacterial peritonitis has no effect on the long-term prognosis of cirrhosis patients with ascites

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Introduction and objectives: Spontaneous bacterial peritonitis (SBP) is a frequent complication to cirrhosis with an unclear long-term prognosis. We aimed to examine its effect on mortality in two independent patient cohorts. Patients and methods: We used Danish healthcare data on cirrhosis patients with a first-time paracentesis in 2000–2014 and data from three randomized controlled trials on satavaptan treatment of ascites conducted in 2006–2008. We used the Kaplan-Meier method to estimate cumulative mortality, and Cox regression to compare the confounder-adjusted mortality hazard for patients with vs. without SBP. Results: In the Danish Healthcare Cohort, we included 1.282 patients of whom 133 (10.4%) had SBP. The SBP patients’ cumulative 4-month mortality was 51.2% (95% CI: 43.0–59.9%) vs. 34.7% (95% CI: 32.0–37.6) in those without SBP. The SBP patients’ confounder-adjusted mortality hazard was 1.54-fold higher (95% CI: 1.18–2.00) in the four months after paracentesis, but was not increased thereafter (confounder-adjusted mortality hazard 1.02, 95% 0.72–1.46). In the satavaptan trial data of 1,198 cirrhosis patients with ascites, the 93 patients with SBP had a cumulative 4-month mortality of 38.6% (95% CI: 29.3–49.7) compared with 11.4% (95% CI: 8.5–15.2) in those without. The SBP patients’ confounder-adjusted mortality hazard ratio was 3.86 (95% CI: 2.44–6.12) during the first four months, and was 1.23 (95% CI: 0.54–2.83) thereafter. Conclusions: In both cohorts of patients with cirrhosis, an SBP episode had a high short-term mortality compared to patients without SBP, and had no lasting effect on the long-term mortality.

TidsskriftAnnals of Hepatology
StatusUdgivet - jul. 2022

Bibliografisk note

Funding Information:
The authors thank Sanofi-Aventis R&D for providing access to the complete trial database from the satavaptan phase III trials in cirrhotic ascites and for permission to perform the analyses included in this publication.

Publisher Copyright:
© 2022 Fundación Clínica Médica Sur, A.C.

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