COMPARISON OF CHILD-PUGH AND MODEL FOR END STAGE LIVER DISEASE SCORES AS PREDICTOR OF SPONTANEOUS BACTERIAL PERITONITIS

Background Spontaneous bacterial peritonitis (SBP) is the presence of ascitic fluid infection in the absence of any surgically treatable source. SBP is a common complication of liver cirrhosis. Aim To compare Child-Pugh (CP) and Model for End Stage Liver Disease (MELD) scores as a predictor of SBP. Subjects Adult liver cirrhosis patients with ascitis who had no antibiotic usage in the previous one month seen at the gastroenterology unit of Aminu Kano Teaching Hospital, Kano. Methods The study is a cross-sectional study of 170 consecutive patients seen between April 2015 to October 2016. Detailed history taking and physical examination were carried out on all patients. Blood samples were taken for liver function test including serum bilirubin, international normalised ratio, serum protein and albumin concentration, and serum creatinine concentration. Diagnostic paracentesis was carried out and samples of ascitic fluid (AF) taken for cell count and differential, microscopy, culture and sensitivity, and AF protein and albumin concentration. CP and MELD scores were computed for all patients. MELD score was calculated using internet medcalculator. SBP was defined as the presence of AF neutrophil count of ≥250 cells/mm3. The concordance (c) statistics equivalent to the area under receiver operating characteristics curve was computed for CP and MELD scores respectively and compared using Delong’s method. Results Of the 170 patients, 64 (37.6%) had SBP. One hundred and ten (64.7%) had CP score B and 60 (35.3%) had CP score of C. Mean CP score was 8.7±1.9. Seventy five (44.1%) had Conclusions Child-Pugh score was superior to MELD score as a predictor of SBP in our study patients.