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Abstract
This study was performed to investigate the risk factors for a first episode of spontaneous
bacterial peritonitis in cirrhotic patients.
One hundred ten cirrhotics with sterile ascites, without previous spontaneous bacterial
peritonitis (SBP), were included from March 1988 to October 1989 and followed up until
October 1990 (follow-up, 46 +/- 3.5 weeks; range, 4-120 weeks).
Twenty-eight patients (25.45%) suffered SBP. In multivariate analysis (Cox's regression
model) including only variables commonly used in clinical practice, ascitic fluid
protein concentration and serum bilirubin level independently correlated with first
SBP development. Using these two variables the relative risk of a first SBP episode
was calculated for each patient. According to the median relative risk coefficient
(1.2), a low-risk group (relative risk, < 1.2) and a high-risk group (relative risk,
> 1.2) were established. Kaplan-Meier estimates of patients free of SBP were significantly
higher in the low-risk group.
The probability of a first SBP episode is significantly influenced by the antimicrobial
capacity of ascitic fluid and hepatic function.