PROGNOSTIC-SIGNIFICANCE OF BACTERIAL-INFECTION IN BLEEDING CIRRHOTIC-PATIENTS - A PROSPECTIVE-STUDY

Background/Aims: In cirrhotic patients, bacterial infection is frequen tly associated with gastrointestinal bleeding and seems to increase mo rtality. The aims of this study were to determine the incidence of bac terial infections in bleeding cirrhotic patients and the influence of infections on the risk of rebleeding and death. Methods: Cirrhotic pat ients admitted for gastrointestinal bleeding who had not received anti microbial chemotherapy in the previous 7 days were included. Blood, ur ine, and ascitic fluid cultures were systematically performed 1, 2, 4, and 7 days after admission. Results: Sixty-four patients were enrolle d. Forty-two bacterial infections were documented in 23 patients (36%) within 7 days of admission. In patients with bacterial infection, mea n Child-Pugh score and mean number of blood units transfused were sign ificantly higher, early rebleeding was more frequent (43.5% vs. 9.8%; P < 0.01), and 4-week mortality was higher (47.8% vs. 14.6%; P < 0.01) . Multivariate analysis only identified bacterial infections as predic tive of early rebleeding (P < 0.02) and a high Child-Pugh score as pre dictive of death (P < 0.001). Conclusions: in bleeding cirrhotic patie nts, bacterial infections only increase the risk of early rebleeding, and mortality is related to the severity of cirrhosis.