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RISS 인기검색어
- 검색키워드
- 저자 : ( Hasnain Ali Shah ) (검색결과 1 건)
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Outcomes of Large Volume Paracentesis in Cirrhotic Patients with Spontaneous Bacterial Peritonitis
( Hafiz Abdul Basit Siddiqui ),( Muhammad Tahir Khan ),( Hasnain Ali Shah ),( Rabeea Azmat ),( Saad Bin Zafar ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims & Background: Bacterial infections are one of the most frequent complication in cirrhosis, particularly in patients with decompensated cirrhosis and accounts for significant mortality. Ascites is one of the most common complications of hepatic cirrhosis (1). In a country like Pakistan where the prevalence of Hepatitis C is on the rise, end stage liver disease is becoming a common scenario (2-4). Spontaneous bacterial peritonitis (SBP) occurs in 10-30% of such patients and is associated with high mortality rate among hospitalized patients (1, 5-7). The diagnosis of SBP through paracentesis is crucial in the management of SBP. SBP should be diagnosed early as for successful treatment of patients. Diagnostic paracentesis facilitates rapid initiation of antimicrobial therapy and permits optimal coverage in case a causative organism identified. However, more recently, the role of paracentesis in management of SBP is also explored through large volume removal of ascitic fluid. Despite the proposed risk of renal failure, Large Volume Paracentesis (LVP) among SBP patients has shown promising results indicated by lesser morbidity and mortality (8). Rationale of the study: Spontaneous bacterial peritonitis is a serious infectious condition with grave outcome in cirrhotic patients. Large volume paracentesis decreases the burden of infective fluid causing further deterioration of condition. Outcomes of LVP in SBP patients are not clearly addressed in previous studies. Furthermore, to date, no study from the country has reported the effect of large volume paracentesis on the management of SBP in hospitalized patients. This study will assess the outcomes of LVP in patients with SBP, both in terms of length of stay, in hospital 6 week mortality. Objectives: To compare the treatment outcomes among patients with and without large volume paracentesis diagnosed with Spontaneous Bacterial Peritonitis Methods: Study design: Analytical Cross-sectional Study Setting: Gastroenterology Unit, The Aga Khan University Hospital, Karachi Study Duration: 2 Years Study population: Patients admitted with Spontaneous Bacterial Peritonitis to Gastroenterology Unit, the Aga Khan University Hospital Sample Size: Using OpenEpi.com online sample size calculator and using the differences in hospital stay among patients with and without delayed paracentesis as 36.84% and 21.48% (8) the sample size was calculated to be 200 at 95% confidence level (100 in each group). Sampling Technique: Consecutive Sampling Inclusion Criteria: Patients admitted with ascites found to have spontaneous bacterial peritonitis on diagnostic paracentesis. 1) Patients with complete records 2) Above 18 and below 75 years of age Exclusion criteria: 1) Incomplete records 2) Secondary peritonitis Data Collection: The data will be extracted from the records and information analyzed will be patient age, gender, whether the patients receive large volume paracentesis or not, the length of hospital stay, and length of ICU stay. No patient will be enrolled for the study and retrospective data analysis will be carried out. Conclusions: Extracted data till now favours that LVP in patients with SBP translates into significantly positive outcomes in terms of length of hospital stay, spcecial care unit stay, need for terlipressin infusions, in hosptial mortality and 6 weeks mortality post large volume paracentesis. Hence LVP shoiuld be performed in patients suffering from SBP.
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