{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:20:54Z","timestamp":1747149654913,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T00:00:00Z","timestamp":1576540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Spontaneous bacterial peritonitis (SBP) is common in hospitalized cirrhotic patients with ascites and carries high mortality. This study aimed to determine whether early diagnostic paracentesis (EDP) &lt;12\u2009h of hospitalization conveys an intermediate\u2010term (6\u2010month) survival benefit in cirrhotic patients diagnosed with SBP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive US veterans with cirrhosis diagnosed with SBP over 13 years at a single VA medical center were reviewed retrospectively. Kaplan\u2010Meyer analyses assessed the effects of EDP on survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 79 cirrhotic patients were diagnosed with SBP (61.8\u2009\u00b1\u20098.8 years, <jats:italic>n<\/jats:italic> = 77 male, <jats:italic>n<\/jats:italic> = 52 [66.8%] Caucasian, <jats:italic>n<\/jats:italic> = 23 [29.1%] African\u2010American). Underlying liver diseases included hepatitis c viral infection (HCV) (17.5%), alcohol (28.6%), alcohol and HCV (30.1%), and cryptogenic\/metabolic (15.9%). Median baseline model for end\u2010stage liver disease (MELD) was 12 (range 6\u201334), and median MELD at presentation was 18. Seven subjects had a history of hepatocellular carcinoma (11.1%), and 26 (41.3%) presented with sepsis. Thirty\u2010three (52.4%) subjects died within 6 months after the SBP admission. Of the subjects, 41 (65.1%) underwent EDP, of which 23 (56.0%) survived at least 6 months, compared to only 7 of the 22 patients (31.8%) undergoing paracentesis &gt;12\u2009h from presentation (<jats:italic>P<\/jats:italic> = 0.057). The maximal benefit of EDP on survival was observed beyond days 14 and 30; at these time points, no statistical difference in mortality was discernable (<jats:italic>P<\/jats:italic> = 0.55 and 0.71). In a multivariate model including age, MELD at admission, hepatocellular cancer, and sepsis criteria, EDP (p 0.034) positively impacted patient survival at 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EDP is associated with improved 6\u2010month mortality in cirrhotic patients with ascites. In this veteran cohort, EDP was as important as MELD as a predictor of intermediate\u2010term survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.12290","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T06:15:31Z","timestamp":1576649731000},"page":"503-506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Survival benefit associated with early detection of spontaneous bacterial peritonitis in veteran inpatients with cirrhotic ascites"],"prefix":"10.1002","volume":"4","author":[{"given":"Luke","family":"Townsend","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Blais","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Huh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leela","family":"Nayak","sequence":"additional","affiliation":[{"name":"St. Louis Veterans Affairs Medical Center John Cochran Division  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7863-5175","authenticated-orcid":false,"given":"Jill E","family":"Elwing","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"},{"name":"St. Louis Veterans Affairs Medical Center John Cochran Division  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory 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