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• W2921674649 abstract "Introduction: Diabetes mellitus type II (DM) is associated with increased risk of infectious complications in cirrhosis, including spontaneous bacterial peritonitis (SBP) in patients with cirrhotic ascites. However, whether comorbid diabetes serves as a risk for poorer clinical outcomes following an episode of SBP is not known. We aimed to determine whether patients with DM are at increased risk for mortality following SBP. Methods: We performed a retrospective review of consecutive cirrhotic patients who were diagnosed with SBP from July 1, 2005 to July 1, 2016 at the John Cochran VA Medical Center. Data included DM, DM duration, insulin use, HbA1c, DM complications (defined as having one of the following: neuropathy, retinopathy or nephropathy), gender, race, age, BMI, etiology of liver disease, complications of cirrhosis (including cancer), MELD score, and 6-month mortality was collected. Kaplan-Meier plots were generated to assess mortality in diabetic vs non-diabetic cirrhotics with SBP, and logistic regression was performed to determine the influence of DM on SBP survival, independent of other patient clinical characteristics. Results: During the 10-year study period, a total of 57 subjects (60.6±8.6 years, 56M, 63.2% Caucasian) were diagnosed with SBP. 23 (40.3%) subjects had a diagnosis of DM. There were no significant differences in gender, BMI, MELD or etiology of liver disease based on DM, though those with DM were older (p=0.03) and more likely to be African-American (p=0.04) than those without DM. The average HbA1c was 6.1±1.2 at time of SBP and 6.7±1.1 for the 5 years prior to SBP. The duration of DM was 10 years in 44%. 65% of DM patients were insulin dependent and 44% had disease complications. 5 (8.9%) of the subjects had been diagnosed with hepatocellular carcinoma, without differences among DM subgroups. Overall 14-day and 6-month mortality was 10.5% and 40.4%, respectively. SBP patients with DM had higher rates of mortality at both 14-days (17.4% vs 5.9%, p=0.16) and 6-months (65.2% vs. 47.1%, p=0.18) (Figure 1). The influence of DM on survival following SBP was independent of DM duration, complications, glycemic control on recent and current HbA1c, and insulin use (p>0 .4 for each). Conclusion: Patients with diabetes were at increased risk for early and intermediate mortality after inpatient admission for SBP. This observation is independent of measures of DM severity and DM complications." @default.
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• W2921674649 date "2018-10-01" @default.
• W2921674649 modified "2023-09-27" @default.
• W2921674649 title "The Association Between Diabetes Mellitus and Mortality Following Spontaneous Bacterial Peritonitis in Cirrhotic Inpatients" @default.
• W2921674649 doi "https://doi.org/10.14309/00000434-201810001-00937" @default.
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