Association of the Model for End-Stage Liver Disease (MELD) Score With Spontaneous Bacterial Peritonitis in Patients With Liver Cirrhosis

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BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common and serious complication of decompensated liver cirrhosis, associated with increased morbidity, mortality, and prolonged hospitalization. Early identification of patients at high risk of SBP is essential to facilitate prompt diagnosis and timely treatment. The Model for End-Stage Liver Disease (MELD) score is a validated prognostic tool that reflects the severity of liver dysfunction and predicts mortality in patients with cirrhosis. However, its role in identifying patients at increased risk of SBP remains uncertain, particularly in resource-limited settings. This study aimed to determine the association between the MELD score and SBP in patients with liver cirrhosis. MATERIALS AND METHODS: A case-control study was conducted in the Department of Medicine at Khyber Teaching Hospital, Peshawar, from March 15 to September 14, 2024. A total of 104 patients with liver cirrhosis and ascites (52 cases with SBP and 52 controls without SBP) were enrolled. SBP was defined as an ascitic fluid neutrophil count >250 cells/mm³. A MELD score >15 was defined as high. Data were analyzed using SPSS Statistics version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). RESULTS: The mean age of the cases was 58.23 ± 8.51 years, and that of the controls was 53.27 ± 10.81 years. Hepatitis C virus was the leading etiology, accounting for 48.1% of cases. A high MELD score was observed in 36 (69.2%) cases and 18 (34.6%) controls. The association between a high MELD score and SBP was statistically significant (ꭓ² = 12.48, p < 0.001), with an odds ratio of 4.25 (95% CI: 1.90-9.53). CONCLUSIONS: A high MELD score is significantly associated with the development of SBP in patients with liver cirrhosis. It serves as a reliable bedside clinical marker for identifying patients at higher risk of this severe complication.

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