Analysis of clinical risk factors and construction of diagnostic model for cirrhotic ascites complicated with spontaneous bacterial peritonitis
Objective To analyze the risk factors of cirrhotic ascites complicated with spontaneous bac-terial peritonitis (SBP),and construct a diagnostic model to better guide clinical treatment.Methods A total of 206 patients with cirrhosis ascites who were hospitalized in the hospital from January 2020 to December 2022 were retrospectively included in the study.According to whether SBP occurred during hospitalization, they were divided into the SBP group (109 cases,52.91％) and non-SBP group (97 cases,47.09％).The clini-cal data and laboratory test indicators of the patients were collected through the electronic medical record sys-tem.Univariate analysis and multivariate logistic regression were used to analyze the independent risk factors of SBP in patients with cirrhotic ascites,and a logistic regression model was established.The diagnostic effica-cy of the model was verified by the area under the receiver operating characteristic (ROC) curve (AUC).Re-sults There were significant differences in white blood cell count (WBC),platelet to white blood cell ratio (PLT/WBC),neutrophil percentage (NEUT％),total bilirubin (TBIL),albumin (ALB),albumin-bilirubin (ALBI) score and platelet-albumin-bilirubin (PALBI) score between the SBP group and non-SBP group (P<0.05).Multivariate logistic regression analysis showed that WBC (OR=6.165,95％CI:2.459-17.145), NEUT％ (OR=2.423,95％CI:1.185-5.055),TBIL (OR=2.850,95％CI:1.402-5.896),ALB (OR=0.346,95％CI:0.137-0.831),ALBI score (OR=2.619,95％CI:1.232-5.674) were independent influen-cing factors of SBP in cirrhotic ascites.The established diagnostic model had good diagnostic efficacy.The Kappa value was 0.441,and the AUC of the model was 0.821 (95％CI:0.764-10.877).When the cut-off value was 0.665,the sensitivity of the diagnostic model was 0.866,the specificity was 0.688,and the Youden index was 0.554.Conclusion WBC,NEUT％,TBIL,ALB and ALBI score are independent risk factors for SBP in cirrhotic ascites.The diagnostic model established by this method has a high diagnostic accuracy for SBP in cirrhotic ascites,which could provide a reference for early clinical diagnosis of SBP.
liver cirrhosisspontaneous bacterial peritonitisrisk factorsdiagnostic model
万方数据
维普
