TY - JOUR
T1 - Prevalence of Peritonitis and the Ascitic Fluid Protein Concentration among Chronic Liver Disease Patients
AU - Hurwich, D. B.
AU - Lindor, K. D.
AU - Hay, J. E.
AU - Gross, J. B.
AU - Kaese, D.
AU - Rakela, J.
PY - 1993/8
Y1 - 1993/8
N2 - The prevalence of spontaneous bacterial peritonitis (SBP) or its variants, bacterascites (BA), and culture‐negative neutrocytic ascites (CNNA), may vary depending on the underlying liver disease and protein content of ascites. In this study, we compared the frequency of peritonitis (SBP, BA, CNNA) upon admission in alcoholic (ALD), cholestatic (CLD), and hepatocellular liver disease (HLD); determined the relationship between Child's class and prevalence of peritonitis; and assessed ascitic total protein as a risk factor for peritonitis. Between January 1989 and April 1991, 113 consecutive patients were admitted with chronic liver disease and ascites (49, ALD; 22, CLD; and 42, HLD). All had admission paracentesis. SBP was defined as polymorphonuclear cell count (PMN) ≥250 mm3 with a positive culture, BA as PMN <250/mm3 and positive culture, and CNNA as PMN 250/mm3 with negative culture. No patients with obvious intraabdominal source for infection (i.e., secondary peritonitis) were included in the analysis. The prevalence of peritonitis was 8/113 (7%); four patients had SBP, one BA, and three CNNA. The occurrence of peritonitis was independent of the type of liver disease (ALD, 8%; CLD, 9%; HDL, 5%). Neither ascitic fluid total protein nor the severity of liver disease (Child's class) predicted the occurrence of peritonitis. We conclude that the occurrence of peritonitis is unrelated to the type of liver disease, and severity of liver disease did not predict the presence of peritonitis. Also, ascitic fluid total protein <1.0 g/dl may not be a sensitive predictor of risk of peritonitis.
AB - The prevalence of spontaneous bacterial peritonitis (SBP) or its variants, bacterascites (BA), and culture‐negative neutrocytic ascites (CNNA), may vary depending on the underlying liver disease and protein content of ascites. In this study, we compared the frequency of peritonitis (SBP, BA, CNNA) upon admission in alcoholic (ALD), cholestatic (CLD), and hepatocellular liver disease (HLD); determined the relationship between Child's class and prevalence of peritonitis; and assessed ascitic total protein as a risk factor for peritonitis. Between January 1989 and April 1991, 113 consecutive patients were admitted with chronic liver disease and ascites (49, ALD; 22, CLD; and 42, HLD). All had admission paracentesis. SBP was defined as polymorphonuclear cell count (PMN) ≥250 mm3 with a positive culture, BA as PMN <250/mm3 and positive culture, and CNNA as PMN 250/mm3 with negative culture. No patients with obvious intraabdominal source for infection (i.e., secondary peritonitis) were included in the analysis. The prevalence of peritonitis was 8/113 (7%); four patients had SBP, one BA, and three CNNA. The occurrence of peritonitis was independent of the type of liver disease (ALD, 8%; CLD, 9%; HDL, 5%). Neither ascitic fluid total protein nor the severity of liver disease (Child's class) predicted the occurrence of peritonitis. We conclude that the occurrence of peritonitis is unrelated to the type of liver disease, and severity of liver disease did not predict the presence of peritonitis. Also, ascitic fluid total protein <1.0 g/dl may not be a sensitive predictor of risk of peritonitis.
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U2 - 10.1111/j.1572-0241.1993.tb03125.x
DO - 10.1111/j.1572-0241.1993.tb03125.x
M3 - Article
C2 - 8393275
AN - SCOPUS:0027213933
SN - 0002-9270
VL - 88
SP - 1254
EP - 1257
JO - The American Journal of Gastroenterology
JF - The American Journal of Gastroenterology
IS - 8
ER -