RESUMO
INTRODUCTION: Spontaneous bacterial peritonitis (SBP) is associated with a high in-hospital mortality rate ranging from 20-40%. The model for end-stage liver disease (MELD) has been suggested as a predictor of in-hospital mortality in patients with SBP. However, the accuracy of the MELD has been questioned, and the integrated MELD (iMELD) score, which incorporates age and serum sodium to the previous model, has been proposed to improve prognostic accuracy. The iMELD has not yet been evaluated in patients with SBP. AIM: To evaluate the accuracy of iMELD and MELD scores in predicting in-hospital mortality in patients with SBP and to identify other prognostic factors of mortality in this group of patients. RESULTS: Of 40 patients analyzed, 65% were male, 50% had hepatitis C, and 27.5% had hepatocellular carcinoma. Mean age was 55.6 years; 25.7% were classified as Child-Pugh class B, and 74.3% as class C. Mean scores were 46.0 and 19.9 for iMELD and MELD, respectively. In-hospital mortality was 40%. Univariate analysis showed that total bilirubin, creatinine, MELD and iMELD scores were significantly associated with in-hospital mortality. The prognostic accuracy was 80% and 77% for iMELD and MELD scores, respectively. CONCLUSION: In conclusion, bilirubin, creatinine, MELD and iMELD were predictors of in-hospital mortality in cirrhotic patients with SPB. iMELD was slightly more accurate than MELD in this group of patients.
Assuntos
Infecções Bacterianas/mortalidade , Mortalidade Hospitalar , Cirrose Hepática/mortalidade , Peritonite/mortalidade , Idoso , Infecções Bacterianas/sangue , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Bilirrubina/sangue , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Creatinina/sangue , Feminino , Hospitalização , Humanos , Cirrose Hepática/sangue , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Peritonite/sangue , Peritonite/diagnóstico , Peritonite/microbiologia , Prognóstico , Fatores de Risco , Índice de Gravidade de Doença , Fatores de TempoRESUMO
Os autores fazem uma revisão das principais hepatites virais ocorridas durante a gestação enfatizando suas manifestações clínicas, repercussões no feto e medidas a serem tomadas.