Liver‐specific scores as predictors of mortality in spontaneous bacterial peritonitis

Abstract

Background Liver-specific scores have been developed and are currently used to predict mortality in cirrhotic patients. The purpose of this study is to analyse and compare their ability to predict mortality in cirrhotic patients with spontaneous bacterial peritonitis. Design and setting Historical cohort study conducted in a public tertiary care teaching hospital. Methods Data from medical records from January 2009 to July 2016 were obtained by searching the hospital electronic database for samples of ascites collected in the period. Electronic and physical medical records were hand analysed and patients were included if they were over 18-year old, with cirrhosis and an ascites fluid compatible with spontaneous bacterial peritonitis. It was included 69 patients. Liver-specific scores were calculated and ROC curves pairwise comparisons were performed using DeLong test. Results Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) was able to predict mortality in 30, 90 and 365 days, with AUROC of 0.75, 0.64 and 0.64 respectively. Values of CLIF-SOFA above 5 was able to predict higher mortality for all patients, with sensitivity of 87%, 74% and 56% and specificity of 52%, 46% and 66% for 28-, 90- and 365-day mortality respectively (P < .05). CLIF-SOFA was able to predict mortality in every time frame for all patients and acute-on-chronic liver failure (ACLF) patients. CLIF-SOFA values above 7 were associated with higher mortality for ACLF patients. Conclusion CLIF-SOFA score was superior to other liver-specific scores for predicting mortality in a cohort of cirrhotic patients admitted due to spontaneous bacterial peritonitis in a teaching hospital in Brazil.