Serum Bilirubin and Spontaneous Bacterial Peritonitis (SBP) in Hepatic Encephalopathy Patients

Abstract

Introduction: Spontaneous bacterial peritonitis (SBP) is an important, frequent and a fatal complication of liver cirrhosis with ascites. Multiple factors have been found to be associated with SBP. The aim of this study is to know the association of serum bilirubin level with SBP. Material and Methods: Two hundred and ninety (290) patients with ascites and hepatic encephalopathy were included in this study. These patients were first checked for spontaneous bacterial peritonitis (SBP). Serum bilirubin was calculated for all these patients and its correlation with spontaneous bacterial peritonitis was then analyzed. Spearman coefficient for the significance of correlation and odd’s ratio for the strength of the correlation was also calculated. Results: Among total 290 patients, 185 patients were having SBP, while 105 were non SBP. Male to female ratio was 1.52 and mean age was 54.7 years. While comparing the serum bilirubin levels between SBP and non SBP patients, the mean (SD) serum bilirubin level of SBP patients was 7.4 (5.5) mg/dL while that of non SBP patients was 3.6 (3.6) mg/dL. The Spearman correlation coefficient for bilirubin with SBP was significant at p value of .01. Odd’s ratio of the two groups for visible hyperbilirubinemia was 5.292, showing the strength of association between SBP and hyperbilirubinemia. Conclusion: High serum bilirubin level is directly related to the occurrence of spontaneous bacterial peritonitis and may be used as a predictor of SBP in patients with ascites.