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Digestive Diseases and Sciences

, Volume 63, Issue 5, pp 1327–1333 | Cite as

Mortality from Spontaneous Bacterial Peritonitis Among Hospitalized Patients in the USA

  • Bolin Niu
  • Brian Kim
  • Berkeley N. Limketkai
  • Jing Sun
  • Zhiping Li
  • Tinsay Woreta
  • Po-Hung Chen
Original Article
  • 307 Downloads

Abstract

Background and Aim

Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis and is associated with significant morbidity and mortality. In this study, we examined the clinical characteristics and risk factors associated with mortality in hospitalized patients presenting with SBP.

Methods

The Nationwide Inpatient Sample was queried for all hospitalizations involving SBP from 2006 to 2014 using the International Classification of Disease-9-CM Code. Logistic regression was performed to evaluate the association between SBP mortality and factors such as age, gender, race/ethnicity, and concomitant medical conditions at presentation (e.g., variceal hemorrhage, hepatic encephalopathy, acute renal failure, coagulopathy, and other infections including pneumonia). The lengths of stay (LOS) and total charges were also examined.

Results

From 2006 to 2014, there were 88,167 SBP hospitalizations with 29,963 deaths (17.6% in-hospital mortality). The mean age of patients who died in the hospital was higher (58.2 years vs. 55.8, p < 0.01) than those who survived the admission. Acute alcoholic hepatitis was noted among a higher proportion of patients who died (7.0 vs. 5.9%, p < 0.01), who were also likely to have more medical comorbidities. In multivariable analysis, older age, female gender, hepatic encephalopathy, coagulopathy, variceal hemorrhage, sepsis, pneumonia, and acute kidney injury were associated with increased in-hospital mortality. This group also had longer LOS (11.6 days vs. 9.1, p < 0.01) and higher total charges ($138,273 vs. $73,533, p < 0.01).

Conclusion

SBP is associated with significant in-hospital mortality, especially in patients with concurrent risk factors. SBP remains a significant burden to the healthcare system.

Keywords

Spontaneous bacterial peritonitis In-hospital Mortality Risk factors Cirrhosis 

Notes

Acknowledgments

This publication was made possible by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number KL2TR001077 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS or NIH.

Compliance with ethical standards

Conflict of interest

The authors do not have any financial disclosures to declare.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyThomas Jefferson University HospitalPhiladelphiaUSA
  2. 2.Division of Gastrointestinal and Liver DiseasesKeck School of Medicine of the University of Southern CaliforniaLos AngelesUSA
  3. 3.Division of Gastroenterology and HepatologyStanford University School of MedicineStanfordUSA
  4. 4.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  5. 5.Division of Gastroenterology and HepatologyJohns Hopkins University School of MedicineBaltimoreUSA

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