Spontaneous Bacterial Peritonitis in Critically Ill Hepatic Patients Adverse Outcomes Detected Echocardiographically and Electro Cardiographically | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 27, Volume 91, Issue 1, April 2023, Pages 3938-3944 PDF (693.53 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2023.294155 | ||
| Authors | ||
| mohammed abdel monem saeed* ; Amr El Fouly; Deyaa Mohamed Ibrahim; Alaa Mohamed Hussein | ||
| Critical care medicine department, faculty of medicine Helwan University,Cairo,Egypt. | ||
| Abstract | ||
| Background: Cirrhotic patients who develop Spontaneous Bacterial Peritonitis (SBP), they most likely have cirrhotic cardiomyopathy, which is characterized by diminished contractility in response to stress despite a generally normal resting cardiac output. Objective: Patients who developed SBP can be assessed prognosticaly by electrocardiography and echocardiography together with scoring systems this was proposed in our study. Patients and Methods: Four hundred cirrhotic patients were included in our study admitted to our general ICU in Critical Care Medicine Department, Faculty of Medicine, Helwan University in the period from May 2020 to September 2022, all patients did not undergo transplant within the study duration and if any patients underwent liver transplant within one year of the last SBP episode were excluded. Patients were classified according to electrocardiographic parameters into low and high QTC and echo cardiographically with tissue Doppler into low and high E/E΄ Ratio with a cut off values > 480 ms for QTc and > 10 for E/E΄ ratio. Results: Four hundred cirrhotic patients were classified into two groups according to the QTC and E/E΄ into low QTc and low E/E΄ group included 200 patients and high QTC and high E/E΄ group included the other 200 patients. Higher QTC and higher E/E΄ were associated with increased in hospital acute kidney’ injury, ICU mortality and 1 year mortality. Conclusion: Cirrhotic patients with SBP associated with high QTC and high E/E΄ are at high risk for acute kidney injury, ICU mortality and 1 year mortality, also, high QTC duration > 480 ms and high E/E΄ ratio of > 10 together with diabetes mellitus, left atrial diameter and left atrial volume, were independent parameters associated with increased mortality at 1-year followup. | ||
| Keywords | ||
| SBP; Cirrhotic cardiomyopathy; QTc duration > 480; E/E΄ >10; 1-year mortality | ||
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