#200 - Early Paracentesis and in-Hospital Mortality in Patients With Decompensated Cirrhosis and Suspected Spontaneous Bacterial Peritonitis

This is the authors' abstract. We don't add key points for this paper.

Introduction and Objectives Delayed diagnostic paracentesis has been associated with worse outcomes in patients with decompensated cirrhosis and suspected spontaneous bacterial peritonitis (SBP). Data from Latin American populations remain limited. To evaluate the association between early paracentesis (24 hours from hospital admission) and in-hospital mortality in patients with decompensated cirrhosis and suspected SBP. Materials and Methods Retrospective observational study including hospitalized adults with decompensated cirrhosis and SBP. Patients were classified according to the timing of paracentesis: early (24 hours) or delayed (>24 hours). Clinical, laboratory, and survival outcomes were compared between groups. Cox regression analysis was performed to evaluate the association between early paracentesis and in-hospital mortality. Results A total of 102 patients were included. Mean age was 54.7±13.6 years, and 63.7% were men. Early paracentesis was performed in 33.3% of patients, whereas 66.7% underwent delayed paracentesis. In-hospital mortality was significantly lower in the early paracentesis group compared with the delayed group (38.2% vs 61.8%, p=0.021). Six-month survival was also higher in patients undergoing early paracentesis (58.8% vs 38.8%, p=0.045). Patients with delayed paracentesis had significantly higher bilirubin levels (14.02 vs 4.52 mg/dL, p=0.007), AST (104.5 vs 59.5 U/L, p=0.001), and ALT levels (52.5 vs 31.5 U/L, p=0.004). On Cox regression analysis, early paracentesis was independently associated with lower in-hospital mortality (HR 0.383, 95% CI 0.164–0.894, p=0.026). Conclusions Early paracentesis within the first 24 hours of admission was independently associated with lower in-hospital mortality in patients with decompensated cirrhosis and suspected SBP. Timely diagnostic paracentesis may represent an important quality-of-care measure.