Predicting and Monitoring Spontaneous Bacterial Peritonitis in Cirrhotic Patients Using the Mansoura Scoring System
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 250
- 主要终点
- Proportion of Patients With Mansoura Score ≥4 Diagnosed With Spontaneous Bacterial Peritonitis (SBP)
研究概览
简要总结
The aim of this prospective study was to examine predictors of SBP in order to develop a noninvasive method to identify or exclude an episode of SBP, for starting early treatment with antibiotics, so decrease morbidity and mortality in these patients.
详细描述
Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascitic fluid without any intra-abdominal, surgically treatable cause.
SBP is the most common bacterial infection in patients with cirrhosis, with a mortality rate exceeding 90% in untreated cases. However, inpatient mortality has been reduced to about 20% with early diagnosis and effective treatment.
Delayed diagnosis increases in-hospital mortality; with each hour of delay in performing paracentesis for SBP diagnosis, mortality increases by approximately 3.3%.
A study conducted in the United States reported that paracentesis was performed within the first 24 hours of admission in only 66% of cirrhotic patients with ascites.
Another study noted that routine paracentesis cannot be performed in all patients with liver cirrhosis. Therefore, delaying diagnosis increases mortality, and it is necessary to find a non-invasive and accurate method for predicting SBP.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients aged >18 years
- •Diagnosed liver cirrhosis
- •Presence of ascites
- •Provided written informed consent
排除标准
- •Use of antibiotics within the previous two weeks
- •Prophylactic treatment for spontaneous bacterial peritonitis (SBP) prior to admission
- •Ascites not related to portal hypertension, including:
- •Peritoneal tuberculosis
- •Peritoneal carcinomatosis
- •Congestive heart failure
- •Renal disease
- •Pancreatitis
- •Hemorrhagic ascites
- •Secondary peritonitis
- •Presence of infections other than SBP, including:
- •Pneumonia
- •Urinary tract infection
- •Skin and soft tissue infection
- •Presence of malignancy Hematologic diseases
- •Use of antiplatelet drugs or non-steroidal anti-inflammatory drugs (NSAIDs)
- •Receipt of platelet or blood transfusion prior to admission
- •Diseases associated with elevated mean platelet volume (MPV), including:
- •Diabetes mellitus
- •Cardiovascular disease
- •Hyperthyroidism
- •Immune thrombocytopenia
- •Myeloproliferative disorders
结局指标
主要结局
Proportion of Patients With Mansoura Score ≥4 Diagnosed With Spontaneous Bacterial Peritonitis (SBP)
时间窗: At hospital admission( within 24 hours)
Primary Outcome Measures Primary Outcome Measure 1: Title: Number of Patients With Mansoura Score ≥4 Diagnosed With Spontaneous Bacterial Peritonitis (SBP).The score ranges from 0 to 4, with higher scores indicating a higher likelihood of SBP (worse outcome). A score ≥4 is considered suggestive of SBP Time Frame: At hospital admission (within 24 hours) Description: Count of patients with a Mansoura score ≥4 who are diagnosed with spontaneous bacterial peritonitis (SBP), defined as ascitic fluid neutrophil count \>250 cells/mm³. Unit of Measure: Number of patients Primary Outcome Measure 2: Title: Proportion of Patients With Mansoura Score ≥4 Diagnosed With Spontaneous Bacterial Peritonitis (SBP) Time Frame: At hospital admission (within 24 hours) Description: Proportion of patients with a Mansoura score ≥4 who are diagnosed with spontaneous bacterial peritonitis (SBP), expressed as a percentage of total study participants. Unit of Measure: Percentage of participants.
次要结局
未报告次要终点
研究者
Amira Mohammed Abdel Mowgod
Principle Investigator
Assiut University