Effect of Serum SAAG Ratio on the Outcome of Diagnosed Patients with (SBP) Spontaneous Bacterial Peritonitis in Comparison to their CTP & Meld Classification

2021 ◽  
Vol 15 (10) ◽  
pp. 3049-3053
Author(s):  
Adil Hassan Chang ◽  
Bushra Kadir ◽  
Ubedullah Bughio ◽  
Laraib Jamali ◽  
Mashooque Ali Samejo ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hospital Mortality ◽  
Serum Albumin ◽  
Spontaneous Bacterial Peritonitis ◽  
Hospital Death ◽  
Staff Nurse ◽  
Medical Sciences ◽  
Albumin Ratio ◽  
Bacterial Peritonitis ◽  
Case Series Study

Objective: To investigate the serum albumin levels among hospitalized patients of chronic Liver disease (CLD) having SBP in Asian Institute of Medical Sciences Hospital Hyderabad, detecting early can potentially reduce its outcome of In-Hospital Mortality. Methodology: The descriptive case series study was conducted from January 2019 to June 2019 at Gastroenterology ward of Asian Institute of Medical Sciences, Hyderabad. All cases of CLD having spontaneous bacterial peritonitis and either of gender were enrolled in the study. Cirrhosis stages were assessed by CTP (Child-Turcot-Pugh) score and MELD (Model for End-stage Liver Disease) score. Serum levels of albumin were taken under the supervision of well-trained staff nurse(s) by following all guideline protocols and taking care of every risk factor and error for minimizing the bias results. The data was analyzed using SPSS version 20. Results: Mean age of the patients was 47.56±13.069 years. sampled serum albumin levels were found less than 2.0mg/dl have much higher in-hospital mortality rate compared to those having serum albumin levels more than 3.0mg/dl. There were also significant differences in outcome (in-hospital mortality) seen among the gender groups: Male vs. female; in-hospital death 42/165 vs. 19/58 (p-0.283). Hospital mortality was significantly high in CTP-C patients compared to CTP-B patients (59/185 vs. 02/38, (p-0.001). Early detection of high-risk patients is critical for better prognosis. Conclusion: It was observed that, there is a high prevalence of cirrhosis and its complications and a significant relationship of in-hospital mortality among patients of SBP and their SAAG (serum Albumin ratios), which clearly signifies that those patients who have serum Albumin ratio lesser than 2.0mg/dl have higher in-hospital mortality as compared to those have serum Albumin ratio lesser than 2.1-3.1mg/dl and more than 3.0mg/dl. Keywords: Cirrhosis, Albumin, Mortality

Ascites

2018 ◽  
Author(s):  
Ehoud Shmueli
Keyword(s):  
Heart Failure ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Liver Function ◽  
Serum Albumin ◽  
Spontaneous Bacterial Peritonitis ◽  
Portal Pressure ◽  
Diagnostic Problem ◽  
Bacterial Peritonitis

Ascites is the accumulation of fluid within the peritoneal cavity. Most patients with ascites usually have a known diagnosis of cirrhosis, malignancy, or heart failure. For patients newly presenting with ascites, the diagnostic problem is usually to differentiate between cirrhosis and malignancy. For patients with established liver disease, ascites represents a deterioration of their liver function, the development of a hepatocellular carcinoma, or another complication. Worsening of preexisting ascites may be due to spontaneous bacterial peritonitis. In malignancy, ascites denotes the development of peritoneal deposits or massive liver metastases. The diagnosis may be obvious from the context, but can be confirmed with imaging and a diagnostic paracentesis. The serum–ascites albumin gradient (SAAG) ([ascitic fluid albumin] − [serum albumin]) reflects portal pressure, and is the key diagnostic test. A SAAG >11 g/l indicates portal hypertension, and therefore probable cirrhosis. A SAAG <11 g/l excludes portal hypertension, and therefore the ascites is not caused by cirrhosis.

The first episode of spontaneous bacterial peritonitis is a threat event in children with end-stage liver disease

2018 ◽  
Vol 30 (3) ◽  
pp. 323-327 ◽  
Author(s):  
Sandra M.G. Vieira ◽  
Fernando P. Schwengber ◽  
Melina Melere ◽  
Marília R. Ceza ◽  
Melina Souza ◽  
...  
Keyword(s):  
Liver Disease ◽  
Spontaneous Bacterial Peritonitis ◽  
First Episode ◽  
Bacterial Peritonitis ◽  
End Stage Liver Disease ◽  
End Stage

scholarly journals Trimethoprim-sulfamethoxazole versus norfloxacin in the prophylaxis of spontaneous bacterial peritonitis in cirrhosis

2005 ◽  
Vol 42 (4) ◽  
pp. 256-262 ◽  
Author(s):  
Roberto Fiolic Alvarez ◽  
Angelo Alves de Mattos ◽  
Esther Buzaglo Dantas Corrêa ◽  
Helma Pinchemel Cotrim ◽  
Tereza Virginia S. B. Nascimento
Keyword(s):  
Liver Disease ◽  
Spontaneous Bacterial Peritonitis ◽  
Protein Concentration ◽  
Serum Bilirubin ◽  
Inclusion Criteria ◽  
Bacterial Peritonitis ◽  
Number Of Patients ◽  
The Mean ◽  
To Receive ◽  
Mean Time

BACKGROUND: The prognosis of patients with chronic liver disease and spontaneous bacterial peritonitis is poor, being of great importance its prevention. AIM: To compare the effectiveness of trimethoprim-sulfamethoxazole versus norfloxacin for prevention of spontaneous bacterial peritonitis in patients with cirrhosis and ascites. PATIENTS AND METHODS: Fifty seven patients with cirrhosis and ascites were evaluated between March 1999 and March 2001. All of them had a previous episode of spontaneous bacterial peritonitis or had ascitic fluid protein concentration <1 g/dL and/or serum bilirubin > 2.5 mg/dL. The patients were randomly assigned to receive either 800/160 mg/day of trimethoprim-sulfamethoxazole 5 days a week or 400 mg of norfloxacin daily. The mean time of observation was 163 days for the norfloxacin group and 182 days for the trimethoprim-sulfamethoxazole group. In the statistical analysis, differences were considered significant at the level of 0.05. RESULTS: According to the inclusion criteria, 32 patients (56%) were treated with norfloxacin and 25 (44%) with trimethoprim-sulfamethoxazole. Spontaneous bacterial peritonitis occurred in three patients receiving norfloxacin (9.4%) and in four patients receiving trimethoprim-sulfamethoxazole (16.0%). Extraperitoneal infections occurred in 10 patients receiving norfloxacin (31.3%) and in 6 patients receiving trimethoprim-sulfamethoxazole (24.0%). Death occurred in seven patients (21.9%) who received norfloxacin and in five (20.0%) who received trimethoprim-sulfamethoxazole. Side effects occurred only in the trimethoprim-sulfamethoxazole group. CONCLUSION: In spite of the reduced number of patients and time of observation, trimethoprim-sulfamethoxazole and norfloxacin were equally effective in spontaneous bacterial peritonitis prophylaxis, suggesting that trimethoprim-sulfamethoxazole is a valid alternative to norfloxacin.

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