What is the mortality rate in spontaneous bacterial peritonitis (SBP)?

Updated: Jul 23, 2019
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

The mortality rate in SBP may be as low as 5% in patients who receive prompt diagnosis and treatment. However, in hospitalized patients, 1-year mortality rates may range from 50-70%. [13] This is usually secondary to the development of complications, such as gastrointestinal bleeding, renal dysfunction, and worsening liver failure. [14] Patients with concurrent renal insufficiency have been shown to be at a higher risk of mortality from SBP than those without concurrent renal insufficiency.

Mortality from SBP may be decreasing among all subgroups of patients because of advances in its diagnosis and treatment. The overall mortality rate in patients with SBP may exceed 30% if the diagnosis and treatment are delayed, but the mortality rate is less than 10% in fairly well-compensated patients with early therapy. As many as 70% of patients who survive an episode of SBP have a recurrent episode within 1 year, and in these patients, the mortality rate approaches 50%. Some studies suggest that the recurrence rate of SBP may be decreased to less than 20% with long-term antibiotic prophylaxis (eg, quinolones, trimethoprim-sulfamethoxazole); however, whether this improves long-term survival without liver transplantation is unclear.


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