Predictors of fifty days in-hospital mortality in patients with culture negative neutrocytic ascites

BMC Gastroenterology

Research Article

Ripu Daman¹  Chinmaya Kumar Bal¹  Vikram Bhatia² 

[1] Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India;Institute of Liver and Biliary Sciences (ILBS), New Delhi, India;

关键词: Culture negative neutrocytic ascites;    Spontaneous bacterial peritonitis;    Liver cirrhosis;    Mortality rate;    Acute kidney injury;    Septic shock;    Model for end stage liver disease;    Aspartate transaminase;    Alanine transaminase;   

DOI  :  10.1186/s12876-017-0621-x

 received in 2016-11-03, accepted in 2017-05-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCulture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population.MethodsWe analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites. The clinical, laboratory parameters, etiology of liver cirrhosis was determined along with the scores like model for end stage liver disease, child turcotte pugh were recorded.ResultsThe 50 day in-hospital mortality rate in culture negative neutrocytic ascites was 39.41% (n = 67). In univariate analysis, means of parameters like total leucocyte count, urea, bilirubin, alanine transaminase, aspartate transaminase, international normalized ratio, acute kidney injury, septic shock, hepatic encephalopathy and model for end stage liver disease were significantly different among survived and those who died (P value ≤0.05). Cox proportional regression model showed the hazard ratio (HR) of acute kidney injury was 2.212 (95% CI: 1.334–3.667), septic shock (HR = 1.895, 95% CI: 1.081–3.323) and model for end stage liver disease (HR = 1.054, 95% CI: 1.020–1.090). Receiver operating characteristics curve showed aspartate aminotransferase (AST) had highest area under the curve 0.761 (95% CI: 0.625–0.785).ConclusionPatients with culture negative neutrocytic ascites have a mortality rate comparable to spontaneous bacterial peritonitis. aspartate aminotransferase, alanine aminotransferase (ALT), acute kidney injury (AKI), model for end stage liver disease (MELD) and septic shock are the independent predictors of 50 days in-hospital mortality in culture negative neutrocytic ascites.

【 授权许可】

CC BY   
© The Author(s). 2017