Model for End-Stage Liver Disease Score Predicts Development of First Episode of Spontaneous Bacterial Peritonitis in Patients With Cirrhosis
To examine whether baseline model for end-stage liver disease (MELD) score in patients with cirrhosis and ascites predicts the future development of first spontaneous bacterial peritonitis (SBP) episode. A retrospective case-control study was performed at three academic centers to select patients ad...
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| Veröffentlicht in: | Mayo Clinic proceedings 2019-09, Vol.94 (9), p.1799-1806 |
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| creator | Khan, Rashid Ravi, Sujan Chirapongsathorn, Sakkarin Jennings, Whitney Salameh, Habeeb Russ, Kirk Skinner, Matt Mudumbi, Sandhya Simonetto, Douglas Kuo, Yong-Fang Kamath, Patrick S. Singal, Ashwani K. |
| description | To examine whether baseline model for end-stage liver disease (MELD) score in patients with cirrhosis and ascites predicts the future development of first spontaneous bacterial peritonitis (SBP) episode.
A retrospective case-control study was performed at three academic centers to select patients admitted with first SBP episode (cases) and those with ascites admitted for decompensation without SBP (controls). Medical records from these centers were reviewed between January 1, 2008, and December 31, 2013. Cases and controls were matched (1:2) for age, sex, and race. Conditional logistic recession models were built to determine whether baseline MELD score (within a month before hospitalization) predicts first SBP episode.
Of 697 patients (308, 230, and 159 from centers A, B, and C, respectively), cases and controls were matched in 94%, 89%, and 100% at three respective centers. In the pooled sample, probability of SBP was 11%, 31%, 71%, and 93% at baseline MELD scores less than or equal to 10, from 11 to 20, from 21 to 30, and greater than 30, respectively. Compared with MELD score less than or equal to 10, patients with MELD scores from 11 to 20, 21 to 30, and greater than 30 had six- (3- to 11-), 29- (12- to 69-), and 115- (22- to 598-) folds (95% CI) risk of SBP, respectively. Based on different MELD score cutoff points, MELD score greater than 17 was most accurate in predicting SBP occurrence. Analyzing 315 patients (152 cases) with available data on ascitic fluid protein level controlling for age, sex, and center, MELD score but not ascitic fluid protein associated with first SBP episode with respective odds ratios of 1.20 (1.14 to 1.26) and 0.88 (0.70 to 1.11).
Baseline MELD score predicts first SBP episode in patients with cirrhosis and ascites. |
| doi_str_mv | 10.1016/j.mayocp.2019.02.027 |
| format | Article |
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A retrospective case-control study was performed at three academic centers to select patients admitted with first SBP episode (cases) and those with ascites admitted for decompensation without SBP (controls). Medical records from these centers were reviewed between January 1, 2008, and December 31, 2013. Cases and controls were matched (1:2) for age, sex, and race. Conditional logistic recession models were built to determine whether baseline MELD score (within a month before hospitalization) predicts first SBP episode.
Of 697 patients (308, 230, and 159 from centers A, B, and C, respectively), cases and controls were matched in 94%, 89%, and 100% at three respective centers. In the pooled sample, probability of SBP was 11%, 31%, 71%, and 93% at baseline MELD scores less than or equal to 10, from 11 to 20, from 21 to 30, and greater than 30, respectively. Compared with MELD score less than or equal to 10, patients with MELD scores from 11 to 20, 21 to 30, and greater than 30 had six- (3- to 11-), 29- (12- to 69-), and 115- (22- to 598-) folds (95% CI) risk of SBP, respectively. Based on different MELD score cutoff points, MELD score greater than 17 was most accurate in predicting SBP occurrence. Analyzing 315 patients (152 cases) with available data on ascitic fluid protein level controlling for age, sex, and center, MELD score but not ascitic fluid protein associated with first SBP episode with respective odds ratios of 1.20 (1.14 to 1.26) and 0.88 (0.70 to 1.11).
Baseline MELD score predicts first SBP episode in patients with cirrhosis and ascites.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.1016/j.mayocp.2019.02.027</identifier><identifier>PMID: 31400909</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Academic Medical Centers ; Aged ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Ascites ; Ascitic fluid ; Bacteria ; Bacterial infections ; Bacterial Infections - complications ; Bacterial Infections - diagnosis ; Bacterial Infections - drug therapy ; Bacterial Infections - mortality ; Bilirubin ; Bleeding ; Case-Control Studies ; Cirrhosis ; Creatinine ; Demography ; Dialysis ; Disease Progression ; Female ; Follow-Up Studies ; Gastroenterology ; Hepatology ; Hospital Mortality ; Hospitalization ; Hospitals ; Humans ; Infections ; Linear Models ; Liver cirrhosis ; Liver Cirrhosis - complications ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - mortality ; Liver Cirrhosis - therapy ; Liver diseases ; Liver Failure - complications ; Liver Failure - diagnosis ; Liver Failure - therapy ; Male ; Medical records ; Medical research ; Middle Aged ; Mortality ; Patients ; Peritonitis ; Peritonitis - complications ; Peritonitis - drug therapy ; Peritonitis - microbiology ; Predictive Value of Tests ; Prophylaxis ; Proteins ; Proton pump inhibitors ; Reference Values ; Retrospective Studies ; Risk Assessment ; Risk groups ; Sepsis ; Severity of Illness Index ; Studies ; Survival Analysis ; Time Factors ; Treatment Outcome</subject><ispartof>Mayo Clinic proceedings, 2019-09, Vol.94 (9), p.1799-1806</ispartof><rights>2019 Mayo Foundation for Medical Education and Research</rights><rights>Copyright © 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.</rights><rights>COPYRIGHT 2019 Frontline Medical Communications Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Sep 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c561t-ae0fcf5b0b302759606350f9d1b8686cf433cf1cea1c4d08887bacf521003bf53</citedby><cites>FETCH-LOGICAL-c561t-ae0fcf5b0b302759606350f9d1b8686cf433cf1cea1c4d08887bacf521003bf53</cites><orcidid>0000-0003-4095-8144 ; 0000-0003-1207-3998</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31400909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khan, Rashid</creatorcontrib><creatorcontrib>Ravi, Sujan</creatorcontrib><creatorcontrib>Chirapongsathorn, Sakkarin</creatorcontrib><creatorcontrib>Jennings, Whitney</creatorcontrib><creatorcontrib>Salameh, Habeeb</creatorcontrib><creatorcontrib>Russ, Kirk</creatorcontrib><creatorcontrib>Skinner, Matt</creatorcontrib><creatorcontrib>Mudumbi, Sandhya</creatorcontrib><creatorcontrib>Simonetto, Douglas</creatorcontrib><creatorcontrib>Kuo, Yong-Fang</creatorcontrib><creatorcontrib>Kamath, Patrick S.</creatorcontrib><creatorcontrib>Singal, Ashwani K.</creatorcontrib><title>Model for End-Stage Liver Disease Score Predicts Development of First Episode of Spontaneous Bacterial Peritonitis in Patients With Cirrhosis</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>To examine whether baseline model for end-stage liver disease (MELD) score in patients with cirrhosis and ascites predicts the future development of first spontaneous bacterial peritonitis (SBP) episode.
A retrospective case-control study was performed at three academic centers to select patients admitted with first SBP episode (cases) and those with ascites admitted for decompensation without SBP (controls). Medical records from these centers were reviewed between January 1, 2008, and December 31, 2013. Cases and controls were matched (1:2) for age, sex, and race. Conditional logistic recession models were built to determine whether baseline MELD score (within a month before hospitalization) predicts first SBP episode.
Of 697 patients (308, 230, and 159 from centers A, B, and C, respectively), cases and controls were matched in 94%, 89%, and 100% at three respective centers. In the pooled sample, probability of SBP was 11%, 31%, 71%, and 93% at baseline MELD scores less than or equal to 10, from 11 to 20, from 21 to 30, and greater than 30, respectively. Compared with MELD score less than or equal to 10, patients with MELD scores from 11 to 20, 21 to 30, and greater than 30 had six- (3- to 11-), 29- (12- to 69-), and 115- (22- to 598-) folds (95% CI) risk of SBP, respectively. Based on different MELD score cutoff points, MELD score greater than 17 was most accurate in predicting SBP occurrence. Analyzing 315 patients (152 cases) with available data on ascitic fluid protein level controlling for age, sex, and center, MELD score but not ascitic fluid protein associated with first SBP episode with respective odds ratios of 1.20 (1.14 to 1.26) and 0.88 (0.70 to 1.11).
Baseline MELD score predicts first SBP episode in patients with cirrhosis and ascites.</description><subject>Academic Medical Centers</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Ascites</subject><subject>Ascitic fluid</subject><subject>Bacteria</subject><subject>Bacterial infections</subject><subject>Bacterial Infections - complications</subject><subject>Bacterial Infections - diagnosis</subject><subject>Bacterial Infections - drug therapy</subject><subject>Bacterial Infections - mortality</subject><subject>Bilirubin</subject><subject>Bleeding</subject><subject>Case-Control Studies</subject><subject>Cirrhosis</subject><subject>Creatinine</subject><subject>Demography</subject><subject>Dialysis</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Linear Models</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - mortality</subject><subject>Liver Cirrhosis - therapy</subject><subject>Liver diseases</subject><subject>Liver Failure - complications</subject><subject>Liver Failure - diagnosis</subject><subject>Liver Failure - therapy</subject><subject>Male</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patients</subject><subject>Peritonitis</subject><subject>Peritonitis - complications</subject><subject>Peritonitis - drug therapy</subject><subject>Peritonitis - microbiology</subject><subject>Predictive Value of Tests</subject><subject>Prophylaxis</subject><subject>Proteins</subject><subject>Proton pump inhibitors</subject><subject>Reference Values</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk groups</subject><subject>Sepsis</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Treatment 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for End-Stage Liver Disease Score Predicts Development of First Episode of Spontaneous Bacterial Peritonitis in Patients With Cirrhosis</title><author>Khan, Rashid ; Ravi, Sujan ; Chirapongsathorn, Sakkarin ; Jennings, Whitney ; Salameh, Habeeb ; Russ, Kirk ; Skinner, Matt ; Mudumbi, Sandhya ; Simonetto, Douglas ; Kuo, Yong-Fang ; Kamath, Patrick S. ; Singal, Ashwani K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c561t-ae0fcf5b0b302759606350f9d1b8686cf433cf1cea1c4d08887bacf521003bf53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Academic Medical Centers</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Ascites</topic><topic>Ascitic fluid</topic><topic>Bacteria</topic><topic>Bacterial infections</topic><topic>Bacterial Infections - complications</topic><topic>Bacterial Infections - diagnosis</topic><topic>Bacterial Infections - drug therapy</topic><topic>Bacterial Infections - mortality</topic><topic>Bilirubin</topic><topic>Bleeding</topic><topic>Case-Control Studies</topic><topic>Cirrhosis</topic><topic>Creatinine</topic><topic>Demography</topic><topic>Dialysis</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infections</topic><topic>Linear Models</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - mortality</topic><topic>Liver Cirrhosis - therapy</topic><topic>Liver diseases</topic><topic>Liver Failure - complications</topic><topic>Liver Failure - diagnosis</topic><topic>Liver Failure - therapy</topic><topic>Male</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patients</topic><topic>Peritonitis</topic><topic>Peritonitis - complications</topic><topic>Peritonitis - drug therapy</topic><topic>Peritonitis - microbiology</topic><topic>Predictive Value of Tests</topic><topic>Prophylaxis</topic><topic>Proteins</topic><topic>Proton pump inhibitors</topic><topic>Reference Values</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk groups</topic><topic>Sepsis</topic><topic>Severity of Illness Index</topic><topic>Studies</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khan, Rashid</creatorcontrib><creatorcontrib>Ravi, Sujan</creatorcontrib><creatorcontrib>Chirapongsathorn, Sakkarin</creatorcontrib><creatorcontrib>Jennings, Whitney</creatorcontrib><creatorcontrib>Salameh, 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Sujan</au><au>Chirapongsathorn, Sakkarin</au><au>Jennings, Whitney</au><au>Salameh, Habeeb</au><au>Russ, Kirk</au><au>Skinner, Matt</au><au>Mudumbi, Sandhya</au><au>Simonetto, Douglas</au><au>Kuo, Yong-Fang</au><au>Kamath, Patrick S.</au><au>Singal, Ashwani K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Model for End-Stage Liver Disease Score Predicts Development of First Episode of Spontaneous Bacterial Peritonitis in Patients With Cirrhosis</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>94</volume><issue>9</issue><spage>1799</spage><epage>1806</epage><pages>1799-1806</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><abstract>To examine whether baseline model for end-stage liver disease (MELD) score in patients with cirrhosis and ascites predicts the future development of first spontaneous bacterial peritonitis (SBP) episode.
A retrospective case-control study was performed at three academic centers to select patients admitted with first SBP episode (cases) and those with ascites admitted for decompensation without SBP (controls). Medical records from these centers were reviewed between January 1, 2008, and December 31, 2013. Cases and controls were matched (1:2) for age, sex, and race. Conditional logistic recession models were built to determine whether baseline MELD score (within a month before hospitalization) predicts first SBP episode.
Of 697 patients (308, 230, and 159 from centers A, B, and C, respectively), cases and controls were matched in 94%, 89%, and 100% at three respective centers. In the pooled sample, probability of SBP was 11%, 31%, 71%, and 93% at baseline MELD scores less than or equal to 10, from 11 to 20, from 21 to 30, and greater than 30, respectively. Compared with MELD score less than or equal to 10, patients with MELD scores from 11 to 20, 21 to 30, and greater than 30 had six- (3- to 11-), 29- (12- to 69-), and 115- (22- to 598-) folds (95% CI) risk of SBP, respectively. Based on different MELD score cutoff points, MELD score greater than 17 was most accurate in predicting SBP occurrence. Analyzing 315 patients (152 cases) with available data on ascitic fluid protein level controlling for age, sex, and center, MELD score but not ascitic fluid protein associated with first SBP episode with respective odds ratios of 1.20 (1.14 to 1.26) and 0.88 (0.70 to 1.11).
Baseline MELD score predicts first SBP episode in patients with cirrhosis and ascites.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>31400909</pmid><doi>10.1016/j.mayocp.2019.02.027</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4095-8144</orcidid><orcidid>https://orcid.org/0000-0003-1207-3998</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0025-6196 |
| ispartof | Mayo Clinic proceedings, 2019-09, Vol.94 (9), p.1799-1806 |
| issn | 0025-6196 1942-5546 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9709904 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Academic Medical Centers Aged Anti-Bacterial Agents - therapeutic use Antibiotics Ascites Ascitic fluid Bacteria Bacterial infections Bacterial Infections - complications Bacterial Infections - diagnosis Bacterial Infections - drug therapy Bacterial Infections - mortality Bilirubin Bleeding Case-Control Studies Cirrhosis Creatinine Demography Dialysis Disease Progression Female Follow-Up Studies Gastroenterology Hepatology Hospital Mortality Hospitalization Hospitals Humans Infections Linear Models Liver cirrhosis Liver Cirrhosis - complications Liver Cirrhosis - diagnosis Liver Cirrhosis - mortality Liver Cirrhosis - therapy Liver diseases Liver Failure - complications Liver Failure - diagnosis Liver Failure - therapy Male Medical records Medical research Middle Aged Mortality Patients Peritonitis Peritonitis - complications Peritonitis - drug therapy Peritonitis - microbiology Predictive Value of Tests Prophylaxis Proteins Proton pump inhibitors Reference Values Retrospective Studies Risk Assessment Risk groups Sepsis Severity of Illness Index Studies Survival Analysis Time Factors Treatment Outcome |
| title | Model for End-Stage Liver Disease Score Predicts Development of First Episode of Spontaneous Bacterial Peritonitis in Patients With Cirrhosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T16%3A32%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Model%20for%20End-Stage%20Liver%20Disease%20Score%20Predicts%20Development%20of%20First%20Episode%20of%20Spontaneous%20Bacterial%20Peritonitis%20in%20Patients%20With%20Cirrhosis&rft.jtitle=Mayo%20Clinic%20proceedings&rft.au=Khan,%20Rashid&rft.date=2019-09-01&rft.volume=94&rft.issue=9&rft.spage=1799&rft.epage=1806&rft.pages=1799-1806&rft.issn=0025-6196&rft.eissn=1942-5546&rft_id=info:doi/10.1016/j.mayocp.2019.02.027&rft_dat=%3Cgale_pubme%3EA605133824%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2284953049&rft_id=info:pmid/31400909&rft_galeid=A605133824&rft_els_id=S0025619619303477&rfr_iscdi=true |