Prognosis

One-year SBP recurrence rates as high as 69% have been reported.[143] Randomized controlled trials comparing antibiotic regimens have described an in-hospital mortality rate of 10% to 28%.[50][120][130]​​[144]​​​ Infection-related mortality rates as low as 0% have been described in patients with uncomplicated SBP at the time of treatment.[145][146]​ The chronic liver failure-sequential organ failure assessment (CLIF-SOFA) can be used to help determine the severity of illness in patients presenting with SBP. Patients with CLIF-SOFA scores ≥7 have >20% mortality and so might benefit from broader empiric antibiotic therapy.[106]​

Survival rates after an episode of SBP are 30% to 50% at 1 year and 25% to 30% at 2 years. Because survival rates after liver transplantation are higher than this, patients should be considered for evaluation for transplantation.[1]

In one systematic review of studies examining prognostic factors in patients with SBP, kidney and liver impairment were shown to be the main prognostic factors of cirrhosis mortality in patients with SBP, with Model for End-Stage Liver Disease (MELD) score and the Charlson index being good markers of survival.[147]​ The in-hospital mortality rate in patients with SBP and kidney dysfunction was found to be 67%, compared with 11% in patients with SBP and normal kidney function.[148] Other prognostic factors under investigation include ascitic polymorphonuclear leukocyte percentage (PMN-%), which has shown promise in assessing risk of death and future SBP.[149]​​

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