- 作者：Maria Poca?/sup> ; Mar Concepció ; n?/sup> ; Meritxell Casas?/sup> ; Cristina Á ; lvarez– ; Urturi?/sup> ; Jordi Gordillo?/sup> ; Virginia Herná ; ndez– ; Gea?/sup> ; Eva Romá ; n?/sup> ; &Dagger ; ; Carlos Guarner– ; Argente?/sup> ; Ignasi Gich§ ; ; German Soriano?/sup> ; &Dagger ; ; gsoriano@santpau.cat ; Carlos Guarner?/sup> ; &Dagger ;
- 关键词：Prognosis ; Infection ; Renal Insufficiency ; Outcome Analysis
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：2012
- 出版时间：March, 2012
- 年：2012
- 卷：10
- 期：3
- 页码：309-315
- 全文大小：673 K
Background & Aims
Intravenous administration of albumin decreases the incidence of renal failure and mortality among patients with spontaneous bacterial peritonitis (SBP). However, it is unclear whether it should be given to all patients with SBP; we evaluated its efficacy.Methods
We analyzed data from all episodes of SBP (n = 216) during a 7-year period that occurred in a nonselected series of 167 patients with cirrhosis. Low-risk episodes (urea <11 mmol/L and bilirubin <68 ¦Ìmol/L) were not treated with albumin, whereas high-risk episodes (urea >11 mmol/L and/or bilirubin >68 ¦Ìmol/L) were or were not given albumin at the discretion of the attending physician.
Results
Sixty-four episodes of SBP (29.6 % ) were low risk and not treated with albumin, whereas 152 (70.4 % ) were high risk; 73 of these (48 % ) were treated with albumin and 79 (52 % ) were not. Renal failure before SBP resolution was less frequent after low-risk episodes than high-risk episodes (4.7 % versus 25.6 % ; P = .001), in-hospital mortality was lower (3.1 % versus 38.2 % ; P < .001), and the 3-month probability of survival was higher (93 % versus 53 % ; P < .001). In an analysis of only the high-risk group, patients who received albumin had lower in-hospital mortality than those not treated with albumin (28.8 % versus 46.8 % ; P = .02) and a greater 3-month probability of survival (62 % versus 45 % ; P = .01).
Conclusions
Albumin therapy increases survival of patients who have high-risk episodes of SBP, although it does not seem to be necessary for patients with low risk of death.