Hung Tsung-Hsing, Wang Chih-Ying, Tsai Chih-Chun, Lee Hsing-Feng
Division of Gastroenterology, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Medicine (Baltimore). 2024 Dec 13;103(50):e40851. doi: 10.1097/MD.0000000000040851.
Spontaneous bacterial peritonitis (SBP) remains a significant concern for patients with cirrhosis. This study aims to reevaluate the trends in both short-term and long-term mortality rates associated with SBP. A retrospective cohort study was conducted using population data obtained from Taiwan's Health and Welfare Data Science Center, Ministry of Health and Welfare. The database, derived from Taiwan's National Health Insurance program, included information from 925 cirrhotic patients discharged after an episode of SBP between January 01, 2014 and December 31, 2015. Each patient's outcomes were tracked for up to 3 years following their initial hospitalization for SBP. The overall mortality rates for cirrhotic patients with SBP at 30 days, 90 days, 1 year, and 3 years were 10.8%, 23.0%, 44.0%, and 60.9%, respectively. Following Cox regression analysis with adjustments for patient age, gender, and underlying medical conditions, the short-term prognostic factors of significance were age (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1.01-1.05, P = .001), concurrent sepsis (HR = 2.73, 95% CI = 1.82-4.08, P < .001), and renal function impairment (HR = 3.28, 95% CI = 2.07-5.18, P < .001). Although the 30-day mortality rate for SBP in cirrhotic patients is around 10%, the long-term mortality remains significantly high. Renal function impairment and the presence of concurrent sepsis serve as indicators of poor short-term prognosis in cirrhotic patients with SBP.
自发性细菌性腹膜炎(SBP)仍是肝硬化患者的一个重大问题。本研究旨在重新评估与SBP相关的短期和长期死亡率趋势。我们使用从台湾卫生福利部卫生福利数据科学中心获得的人口数据进行了一项回顾性队列研究。该数据库源自台湾国民健康保险计划,包含了2014年1月1日至2015年12月31日期间因SBP发作后出院的925例肝硬化患者的信息。在每位患者因SBP首次住院后,对其结局进行了长达3年的跟踪。肝硬化合并SBP患者在30天、90天、1年和3年时的总体死亡率分别为10.8%、23.0%、44.0%和60.9%。在对患者年龄、性别和基础疾病进行调整的Cox回归分析后,具有显著意义的短期预后因素为年龄(风险比[HR]=1.03,95%置信区间[CI]=1.01-1.05,P=.001)、并发脓毒症(HR=2.73,95%CI=1.82-4.08,P<.001)和肾功能损害(HR=3.28,95%CI=2.07-5.18,P<.001)。尽管肝硬化患者SBP的30天死亡率约为10%,但其长期死亡率仍然显著较高。肾功能损害和并发脓毒症的存在是肝硬化合并SBP患者短期预后不良的指标。