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Abstract Spontaneous bacterial peritonitis (SBP) is a potentially fatal condition, characterized by infection of ascitic fluid (AF) in the absence of any intra-abdominal surgically treatable source of infection. It is the most frequent and severe complication of cirrhotic ascites. SBP is a condition that requires a high index of suspicion, rapid and accurate diagnosis, in addition to prompt and effective therapy. The prevalence of SBP ranges from 10% to 30% and mortality from 10% to 32% in hospitalized patients. Diagnosis of SBP is based on ascitic fluid polymorphonuclear leukocytes (PMN) count ≥250/mm3 or ascitic fluid culture is positive. Early antibiotic therapy is extremely important for the successful treatment of SBP and reducing mortality. Antibiotic prophylaxis in ascitic patients with variceal hemorrhage decreases the risk of SBP. Therefore, the development of new biomarkers to diagnose SBP or predict the mortality is significant for improving the prognosis of patients with SBP. The mortality rate in SBP may be as low as 5% in patients who receive prompt diagnosis and treatment. However, in hospitalized patients, 1-year mortality rates may range from 50-70%. This is usually secondary to the development of complications, such as gastrointestinal bleeding, renal dysfunction, and worsening liver failure. Patients with concurrent renal insufficiency have been shown to be at a higher risk of mortality from SBP than those without concurrent renal insufficiency. Summary 68 Mortality from SBP may be decreasing among all subgroups of patients because of advances in its diagnosis and treatment. The overall mortality rate in patients with SBP may exceed 30% if the diagnosis and treatment are delayed, but the mortality rate is less than 10% in fairly well-compensated patients with early therapy. Our Study was prospective diagnostic accuracy test study which was carried out on Ninety Patients selected from wards of Internal Medicine Department of: Menoufia University Hospitals, National Liver Institute at Shibin Al-Kum. & El Helal Health Insurance Hospital at Shibin Al-Kum, from Abril 2020 to May 2021. A written informed consent will be obtained from every eligible patient. Patients will be informed about the study objectives, methodology, risk, and benefit. The study’s protocol will be reviewed and approved by ethics committee or audit department of Faculty of Medicine, Menoufia University. Our results are: The Ascetics Fluid PMN cell count as a Diagnostic Marker for SBP at a Cut of Point (>250 cell/ml) and Guide Prognostic for in hospital Cirrhotic Hepatic Patients at a Mean of 402.5±199.1 and Range of 46-900 and patient’s results divided into three subgroups according to mortality(Low risk) 125- 250 cell/ml, (intermediate risk 250- 500 cell/ml, high risk > 500 Sensitivity 80% and Specificity 55.7 % Of Negative Predictive Value = 93% Positive Predictive Value = 27% And Accuracy 60%. The Ascetics Fluid PGE2 as a Diagnostic Marker for SBP at a mean 44.39.3 and Range of 28-58 and a Guide Prognostic for in hospital Cirrhotic Hepatic Patients at a Mean of 34.43.2 and Range of Summary 69 28.4-38.3 and Sensitivity 93.3% and Specificity 96 % Of Negative Predictive Value = 99% Positive Predictive Value = 82% And Accuracy 96%. There is no significant difference between two groups as regard age & gender and Residency. There is no significant difference between two groups regardly (Child p score- MELD score). Significant difference between two groups regardly ascitic PMN cell count and Ascitic fluid PGE2. There is significant difference between two groups regardly PMN cell which indicate that the higher Ascitic PMN cell count the higher in hospital mortality rate there is significant difference between two groups regardly Ascitic fluid PGE2 which indicate that the lower Ascitic fluid PGE2 the higher in hospital mortality rate in hepatic cirrhotic patient. |