Impact of Spontaneous Bacterial Peritonitis and Cellulitis on Outcome of Cirrhosis and Effect of Early Intervention on The Prognosis- A Prospective Cross-Sectional Study.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 4505-4514
AbstractBackground: Spontaneous bacterial peritonitis and cellulitis are the two major prevalent infections in cirrhotic patients and responsible for morbidity and mortality. The present study was aimed to evaluate the burden of these two infections in cirrhotic patients.
Materials and Methods: This prospective study was conducted in 120 cirrhotic patients at a tertiary hospital in Chennai. The patients were divided into three groups, SBP group including 57 patients, Cellulitis group including 58 patients and Common group including 5 patients with both infections.Time of hospitalisation and antibiotics therapy intiation, Site of cellulitis (upper limb, lower limb, scrotal), per abdomen examination for ascites and tenderness was noted. Laboratory investigations containing complete blood count (CBC), liver function test (LFT), international normalized ratio (INR), renal function test (RFT), Alpha feto protein, HBsAg, anti HCV, ultrasound abdomen, upper gastrointestinal endoscopy, ascitic fluid analysis, polymorphonuclear neutrophil count, wound, blood and ascitic fluid cultures were analysed.Prognostic scores like CTP (Child Turcott Pugh) and MELD (Model for End stage Liver Disease) was calculated. Interventions done like debridement, albumin injection, terlipressin injection, need for hemodialysis etc. also were analysed. The obtained data was analysed using Student’s T-test and Chi-square test.
Results:The study reports revealed comparable incidence and male preponderance. Out of 120 total patients, 22 died (18.33%) during the course of hospitalization. Mortality was 13 in the SBP group (22.8%), 6 in cellulitis group (10%) (p- 0.055)and 3 in combined infection group (60%).
Conclusion:In this study, spontaneous bacterial peritonitis has shown more mortality and,the prevalence of SBP and cellulits were comparable in cirrhotic patients.
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