Correlation between meld score and sbp in patients with cirrhosis and ascites

Author: 
Mayank Jain, Rajiv Baijal and Sri Prakash Jaiswal

Aim: To determine whether a greater MELD score is associated with a greater risk of development of spontaneous bacterial peritonitis
Material and methods: This prospective study enrolled 248 consecutive patients with cirrhosis and ascites. After excluding patients who were immunosuppressed, had history of prior antibiotic use, had previous episodes of SBP and had other confounding etiological factors for ascites, 125 patients were included in the study. SBP was defined as ascetic fluid PMN count > 250 /cu.mm. The odds ratio for development of SBP associated with MELD score and grouped MELD score was calculated (<15, 16-24, >25).Variables like albumin, INR, creatinine, creatinine clearance and ascItic fluid analysis measurements were compared in the two groups
Results: The prevalence of SBP was 20%. The mean MELD score in SBP group was 24.92 and in the non SBP group were 19.05. Patients with MELD >25 had an odds ratio of 7(p=0.0001) for SBP as compared to patients with MELD < 15. Ascitic fluid PMN count, serum albumin, serum creatinine and creatinine clearance were significantly altered in the SBP group.
Conclusion: The prevalence of SBP was 20%. Increasing MELD score is independently associated with a greater risk of SBP. The risk of developing SBP is seven times higher if MELD score is >25 as compared to a score of < 15.

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DOI: 
DOI: http://dx.doi.org/10.24327/ijcar.2017.5685.0778