ABSTRACT FINAL ID: 2037
TITLE: Predictors of mortality in patients hospitalized with spontaneous bacterial peritonitis: Analysis of National Inpatient Sample, 2009-2011
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Background: Spontaneous bacterial peritonitis (SBP) is a common, life-threatening bacterial infection in patients with cirrhosis and ascites. The objective of this study was to determine risk factors associated with mortality in hospitalized SBP patients in the United States using the 2009-2011 National Inpatient Sample (NIS). Methods: Hospitalizations associated with primary or secondary diagnosis were identified based on the ICD-9-CM coding for SBP, 567.23. Multivariate logistic regression was used to estimate the odds of mortality according to patient and hospital factors. Results: There were 56,966 patients hospitalized with SBP, and overall in-hospital mortality was 17.7%. Those who died during hospitalization were more likely to be older (mean age 58.0 vs. 56.1 yrs, p<0.001), have longer length of stay (11.8 vs. 9.3 days, p<0.001), and higher mean total charges ($139,695 vs. $76,111, p<0.001). Those admitted with SBP predominantly had governmental insurance (Medicare 36.7%, Medicaid 23.0%), while 7.8% were self-pay and 27.1% had private insurance. Among SBP patients who died, 57% had a median household income less than $50,000: $1-$38,999 (31.3%); $39,000-$47,999 (25.7%). In the multivariate logistic regression analyses, age, non-Hispanic ethnicity, acute liver injury, hepatic encephalopathy, hepato-renal syndrome, dialysis, hepatocellular carcinoma, sepsis, teaching hospitals, and government-owned hospitals were significantly associated with inpatient mortality (Table 1). Conclusion: SBP is associated with significant in-hospital mortality and healthcare cost. Sepsis, hepatorenal syndrome, and acute liver injury were strongly associated with inpatient mortality. More effective methods for early identification, prevention and treatment of SBP are needed.