Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark; Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark; Evotec ID, Lyon, France.
Ann Hepatol. 2022 Jul-Aug;27(4):100711. doi: 10.1016/j.aohep.2022.100711. Epub 2022 Apr 18.
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.
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.
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.
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.
自发性细菌性腹膜炎（SBP）是肝硬化的常见并发症，其长期预后尚不清楚。我们旨在通过两个独立的患者队列来检查其对死亡率的影响。
我们使用了丹麦的医疗保健数据，其中包括 2000 年至 2014 年间首次进行腹腔穿刺术的肝硬化患者的数据，以及 2006 年至 2008 年间进行的 Satavaptan 治疗腹水的三项随机对照试验的数据。我们使用 Kaplan-Meier 方法估计累积死亡率，并使用 Cox 回归比较 SBP 患者与无 SBP 患者的死亡率校正危险比。
在丹麦医疗保健队列中，我们纳入了 1282 名患者，其中 133 名（10.4%）患有 SBP。SBP 患者的 4 个月累积死亡率为 51.2%（95%CI：43.0-59.9%），而无 SBP 患者为 34.7%（95%CI：32.0-37.6%）。在腹腔穿刺术后的四个月内，SBP 患者的死亡率校正危险比为 1.54 倍（95%CI：1.18-2.00），但此后并未增加（校正死亡率危险比为 1.02，95%CI：0.72-1.46）。在 Satavaptan 试验的 1198 名腹水肝硬化患者数据中，93 名患有 SBP 的患者在 4 个月内的累积死亡率为 38.6%（95%CI：29.3-49.7%），而无 SBP 的患者为 11.4%（95%CI：8.5-15.2%）。在最初的四个月内，SBP 患者的死亡率校正危险比为 3.86（95%CI：2.44-6.12），此后为 1.23（95%CI：0.54-2.83）。
在两个肝硬化患者队列中，SBP 发作的短期死亡率均明显高于无 SBP 的患者，且对长期死亡率没有持久影响。
