Study of prognostic factors associated with in hospital mortality in patients of liver cirrhosis with spontaneous bacterial peritonitis.

Introduction: Patients with liver cirrhosis and ascites requires prompt recognition and treatment of spontaneous bacterial peritonitis (SBP). The model for end stage liver disease (MELD) score and integrated MELD (iMELD) has been used as predictors of mortality in patients with SBP along with other laboratory parameters. Material & Methods: This prospective observational study was done over a period of two years (Jan 2018 to Dec. 2019). In the present study 60 adult patients both male and female having cirrhosis with Spontaneous bacterial peritonitis (SBP) were included. Laboratory variables included were serum creatinine, total bilirubin, Prothrombin time, serum albumin, serum sodium, and ascitic fluid PMN cell count, MELD & iMELD score was calculated according to the United Network for Organ Sharing (UNOS) formula Results: In hospital mortality in our study came out to be 40%. 25% patients fall under Child-Turcotte-Pugh B and 75% patients fall under Child-Turcotte-Pugh score C .The mean MELD and iMELD score in survivors group patients were 17.88±3.17 and 44.86 ± 4.18 compared from non-survivor group patients who died was 24.75±4.6 and 48.41±4.18 which was highly significant ( P≤ 0.00). We identified MELD and iMELD score have high predictive value of mortality than other laboratory parameters. Conclusion: MELD score, iMELD score, PMN cell count in ascitic fluid , total bilirubin, serum creatinine, serum sodium,INR were found as prognostic factors for prediction of mortality in patients with SBP.