The first episode of spontaneous bacterial peritonitis is a threat event in children with end-stage liver disease

The first episode of spontaneous bacterial peritonitis is a threat event in children with... ObjectiveStudies on native liver survival (NLS) after the first episode of spontaneous bacterial peritonitis (SBP) are rare. Our objective was to evaluate NLS in children up to 1 year after SBP.MethodsA historical cohort study of 18 children followed after the first episode of SBP was conducted. NLS, in-hospital mortality, causes of death, and rate of multidrug-resistant organisms were reported.ResultsBiliary atresia was the most prevalent diagnosis (72.2%); all were Child–Pugh C, and the median age was 1.0 year. The probability of NLS was 77.8, 27.8, and 11.1% at 1, 3 and 6 months, respectively. At 9 months, no child had the native liver. In-hospital mortality was 38.9%, and the main causes of death were septic shock and acute-on-chronic liver failure. Escherichia coli was the predominant organism cultured. Multidrug-resistant organisms were not detected. The cumulative probability of NLS was 77.8% at 1 month, 27.8% at 3 months, and 11.1% at 6 months. At 9-month follow-up, none of children had their native liver. Ascites PMN count cell more than 1000 cells/mm3, positive ascites culture, and prolonged international normalized ratio reached a significant value as predictive factors of NLS and were selected for multivariate analysis. We did not identify independent predictors of survival.ConclusionDevelopment of SBP was a late event in children and had a high effect on NLS. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Gastroenterology & Hepatology Wolters Kluwer Health

The first episode of spontaneous bacterial peritonitis is a threat event in children with end-stage liver disease

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
0954-691X
eISSN
1473-5687
D.O.I.
10.1097/MEG.0000000000001046
Publisher site
See Article on Publisher Site

Abstract

ObjectiveStudies on native liver survival (NLS) after the first episode of spontaneous bacterial peritonitis (SBP) are rare. Our objective was to evaluate NLS in children up to 1 year after SBP.MethodsA historical cohort study of 18 children followed after the first episode of SBP was conducted. NLS, in-hospital mortality, causes of death, and rate of multidrug-resistant organisms were reported.ResultsBiliary atresia was the most prevalent diagnosis (72.2%); all were Child–Pugh C, and the median age was 1.0 year. The probability of NLS was 77.8, 27.8, and 11.1% at 1, 3 and 6 months, respectively. At 9 months, no child had the native liver. In-hospital mortality was 38.9%, and the main causes of death were septic shock and acute-on-chronic liver failure. Escherichia coli was the predominant organism cultured. Multidrug-resistant organisms were not detected. The cumulative probability of NLS was 77.8% at 1 month, 27.8% at 3 months, and 11.1% at 6 months. At 9-month follow-up, none of children had their native liver. Ascites PMN count cell more than 1000 cells/mm3, positive ascites culture, and prolonged international normalized ratio reached a significant value as predictive factors of NLS and were selected for multivariate analysis. We did not identify independent predictors of survival.ConclusionDevelopment of SBP was a late event in children and had a high effect on NLS.

Journal

European Journal of Gastroenterology & HepatologyWolters Kluwer Health

Published: Mar 1, 2018

References

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