Low ascitic fluid total protein levels is not associated to the development of spontaneous bacterial peritonitis in a cohort of 274 patients with cirrhosis

TY - JOUR

T1 - Low ascitic fluid total protein levels is not associated to the development of spontaneous bacterial peritonitis in a cohort of 274 patients with cirrhosis

AU - Mo, Silje

AU - Bendtsen, Flemming

AU - Wiese, Signe Skovgaard

AU - Kimer, Nina

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: Spontaneous bacterial peritonitis (SBP) is a complication to decompensated cirrhosis. Fluoroquinolones may prevent SBP. However, predictive markers for SBP are wanted. Guidelines suggest that patients with ascitic fluid protein below 15 g/l receive fluoroquinolones to prevent SBP. This study aimed to assess the clinical utility of low ascitic fluid protein in predicting SBP in patients with cirrhosis and ascites. Methods: A total of 274 patients with cirrhosis and ascites underwent paracentesis between January 2010 and June 2015. Patients were followed until two years, development of SBP, initiation of ciprofloxacin, death or liver transplantation. Data were compared between groups of patients with ‘high’ or ‘low’ ascitic protein. Results: SBP developed in 31 patients (11.3%). No difference in mean ascitic fluid protein levels were found (SBP, mean: 8.5 g/l and no SBP 8.2 g/l, p = .825). SBP developed at equal rates in patients with ‘high’ or ‘low’ ascitic protein (10.8% (≤15 g/l) and 14.0% (>15 g/l), p = .599). The same trend was observed when adjusting the threshold below 10 g/l (11.9% (≤10 g/l) and 10.2% (>10 g/l), p = .697). Conclusions: Low ascitic fluid protein does not predict SBP in patients with cirrhosis and ascites. Better markers are needed.

AB - Background: Spontaneous bacterial peritonitis (SBP) is a complication to decompensated cirrhosis. Fluoroquinolones may prevent SBP. However, predictive markers for SBP are wanted. Guidelines suggest that patients with ascitic fluid protein below 15 g/l receive fluoroquinolones to prevent SBP. This study aimed to assess the clinical utility of low ascitic fluid protein in predicting SBP in patients with cirrhosis and ascites. Methods: A total of 274 patients with cirrhosis and ascites underwent paracentesis between January 2010 and June 2015. Patients were followed until two years, development of SBP, initiation of ciprofloxacin, death or liver transplantation. Data were compared between groups of patients with ‘high’ or ‘low’ ascitic protein. Results: SBP developed in 31 patients (11.3%). No difference in mean ascitic fluid protein levels were found (SBP, mean: 8.5 g/l and no SBP 8.2 g/l, p = .825). SBP developed at equal rates in patients with ‘high’ or ‘low’ ascitic protein (10.8% (≤15 g/l) and 14.0% (>15 g/l), p = .599). The same trend was observed when adjusting the threshold below 10 g/l (11.9% (≤10 g/l) and 10.2% (>10 g/l), p = .697). Conclusions: Low ascitic fluid protein does not predict SBP in patients with cirrhosis and ascites. Better markers are needed.

KW - Ascites

KW - ascitic fluid protein

KW - fluoroquinolone prophylaxis

KW - liver cirrhosis

KW - spontaneous bacterial peritonitis

U2 - 10.1080/00365521.2017.1411973

DO - 10.1080/00365521.2017.1411973

M3 - Journal article

C2 - 29214880

AN - SCOPUS:85037986315

SN - 0085-5928

VL - 53

SP - 200

EP - 205

JO - Scandinavian Journal of Gastroenterology. Supplement

JF - Scandinavian Journal of Gastroenterology. Supplement

IS - 2

ER -