Clinical, biochemical and inflammatory predictors of mortality in patients with spontaneous bacterial peritonitis

Background: Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis. It contributes to high morbidity and mortality in this population. In-hospital mortality of SBP ranges between 20% and 40%, suggesting that further refinements are essential in managing SBP. Early recognition of high-risk patients would enable us to reduce the short-term mortality.Objective: The current study aimed to evaluate the value of clinical, biochemical and inflammatory markers in the prediction of 1-month and 3-month cumulative mortality in patients with SBP.Patients and methods: Two hundred patients with a confirmed diagnosis of SBP were enrolled. They were admitted and received the proper treatment at the National Liver Institute Hospital-Menoufia University, Egypt. Patients were prospectively followed up for mortality over a period of three months. Predictors of mortality were assessed and analyzed.Results: Mortality rates were 20% and 41% at 1 month and 3 month respectively. Our findings showed that low blood pressure, abdominal pain, fever, higher Child-Pugh score, MELD score, serum bilirubin, INR, serum creatinine, C-reactive protein to albumin (CRP/Albumin) ratio, neutrophil–lymphocyte ratio (NLR), massive splenomegaly and large ascites have been demonstrated as risk factors associated with short-term mortality.Conclusion: SBP carries a high risk of mortality among cirrhotic patients. Clinical parameters (low blood pressure, abdominal pain, fever, massive splenomegaly and large ascites), prognostic scores (Child-Pugh and MELD) and inflammatory markers (CRP, CRP/albumin ratio, and NLR) seem to be accurate and reliable tools that could independently predict short-term mortality in patients with SBP

Comparative evaluation of cardiac health in patients with chronic liver disease secondary to HCV, HBV, and NASH

Background: There is a documented relationship between chronic liver disease and cardiac dysfunction. The current investigation aims to compare the cardiac health in patients with chronic liver disease secondary to HCV, HBV, and NASH. Patients and Methods: This prospective study included 150 patients divided into three groups; Group I (50 HCV cases), Group II (50 HBV cases), and Group III (50 NASH cases). Each group was subdivided into two equal subgroups; the A subgroup included patients without liver cirrhosis, and the B subgroup included patients with liver cirrhosis. The assessment included laboratory biomarkers, transabdominal ultrasound, fibroscan, echocardiography, and carotid doppler. Results: EF had mean values of 62.58, 62.8, and 64.14%, whereas prolonged QT interval was noted in 30%, 40%, and 37% of patients in the three groups, respectively. E/A ratios > 1 were detected in 70%, 66%, and 72% of patients, while carotid atherosclerosis was detected in 28%, 28%, and 32% in the same three groups, respectively. All of the previous parameters were comparable between the three main groups. On comparing subgroups A to B, prolonged QT intervals, carotid atherosclerosis, and decreased EF were more noticed in the latter.&nbsp