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This retrospective observational cohort study evaluated whether composite biomarkers—blood urea nitrogen/albumin ratio (BAR), red cell distribution width/albumin ratio (RAR), and neutrophil-to-lymphocyte ratio (NLR)—predict in-hospital mortality in SBP patients. Receiver operating characteristic analysis and logistic regression assessed prognostic performance in adults diagnosed between March 2022 and October 2024.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-prognostic-value-of-biomarkers-in-patients-diagnosed-with-spontaneous-bacterial-peritonitis/461463/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-prognostic-value-of-biomarkers-in-patients-diagnosed-with-spontaneous-bacterial-peritonitis/461463.png","ImageObject",300,407,{"name":92,"@type":93},"Danger Angel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the study objective for patients with spontaneous bacterial peritonitis?","Question",{"text":113,"@type":114},"To evaluate whether composite biomarkers (BAR, RAR, and NLR) can predict in-hospital mortality in SBP patients in the emergency department.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were patients diagnosed with spontaneous bacterial peritonitis in the study?",{"text":118,"@type":114},"SBP diagnosis was confirmed by ascitic fluid leukocyte count greater than 250/mm3.",{"name":120,"@type":111,"acceptedAnswer":121},"Which biomarker performed best for predicting in-hospital mortality?",{"text":122,"@type":114},"The blood urea nitrogen/albumin ratio (BAR) was the strongest predictor, outperforming both RAR and NLR, with the highest prognostic performance reported.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},461463,1790794315,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},962090769052,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Article  \nThe Prognostic Value of Biomarkers in Patients Diagnosed with Spontaneous Bacterial Peritonitis  \nSüleyman Kırık 1, Mehmet Göktu ˘g Efgan 1, Ejder Saylav Bora 1, Efe Kanter 1, Ecem Ermete Güler 1 and Tutku Duman ¸Sahan 2, *  \nAcademic Editor: Jun Kato  \nReceived: 8 December 2025  \nRevised: 20 December 2025  \nAccepted: 25 December 2025  \nPublished: 27 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Emergency Medicine, Faculty of Medicine, Izmir Katip Çelebi University, 35100 Izmir, Turkey; [kiriksuleyman2107@outlook.com](kiriksuleyman2107@outlook.com) (S.K.); [goktugefgan@gmail.com](goktugefgan@gmail.com) (M.G.E.); [saylavbora@hotmail.com](saylavbora@hotmail.com) (E.S.B.); [efekanter@hotmail.com](efekanter@hotmail.com) (E.K.); [ecemermete@hotmail.com](ecemermete@hotmail.com) (E.E.G.)  \n2 Department of Emergency Medicine, Izmir Çe¸sme Alper Çizgenakat State Hospital, 35950 Izmir, Turkey  \n* Correspondence: [tutkuduman75@gmail.com](tutkuduman75@gmail.com)  \nAbstract  \nBackground: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication of cirrhosis associated with high morbidity and mortality. Early risk stratification remains challenging due to the invasive nature of ascitic polymorphonuclear cell counting and the limited sensitivity of conventional markers. Novel composite biomarkers such asthe blood urea nitrogen/albumin ratio (BAR), red cell distribution width/albumin ratio (RAR), and neutrophil-to-lymphocyte ratio (NLR) may offer practical prognostic value. This study aimed to evaluate the predictive power of these biomarkers for in-hospital mortality in patients diagnosed with SBP in the emergency department. Methods: This retrospective, observational, cohort study included adult patients diagnosed with SBP between March 2022 and October 2024 . SBP diagnosis was confirmed by ascitic fluid leukocyte count > 250/mm3. Demographic data, laboratory parameters, and clinical outcomes were obtained from hospital records. RAR and BAR ratios were calculated at admission. Outcomes were analyzed according to ward/intensive care unit (ICU) admission and inhospital mortality. Receiver operating characteristic (ROC) analysis and logistic regression were performed to assess prognostic performance. Results: A total of 112 patients were included (mean age 63.44 ± 13.16 years, 56.3% male) . In-hospital mortality was 43.8% . Both BAR and RAR ratios were significantly higher in non-survivors (p = 0.016 and p = 0.001, respectively) . BAR showed the highest prognostic performance (Area under the curve 0.761), with an optimal cutoff > 1.86 (sensitivity 64.44%, specificity 79.66%) . RAR had an area under the curve (AUC) of 0.638, and NLR had an AUC of 0.658 . Conclusions: Among the evaluated biomarkers, BAR emerged as the strongest predictor of in-hospital mortality in SBP, outperforming both RAR and NLR. Although albumin alone was not predictive, its use in composite ratios improved prognostic accuracy. These easily accessible biomarkers may support early risk stratification in emergency settings.  \nKeywords: spontaneous bacterial peritonitis; BUN/albumin ratio; RDW/albumin ratio; in-hospital mortality  \n1. Introduction  \nSpontaneous bacterial peritonitis (SBP) is a serious and potentially fatal infection that develops in patients with cirrhosis and ascites. The clinical picture is characterized by a marked increase in renal failure and mortality risk, making early diagnosis and appropriate  \ntreatment strategies crucial [1] . Bacterial translocation, immune response disorders, and weakened intra-abdominal defence mechanisms play a key role in the pathogenesis of SBP. Recent research has focused on the use of various laboratory markers to accelerate diagnosis and improve prognosis [2] . In this context, composite indices such as albu","cbCaiaVmzpjaXnxg","https://ap.wps.com/l/cbCaiaVmzpjaXnxg","pdf",520607,13,"English","# Abstract\n# Introduction\n## Background and clinical importance\n## Biomarkers and ratios\n## Albumin, RDW, and renal markers\n## Peritoneal infection spectrum and differential diagnosis","[{\"question\":\"What was the study objective for patients with spontaneous bacterial peritonitis?\",\"answer\":\"To evaluate whether composite biomarkers (BAR, RAR, and NLR) can predict in-hospital mortality in SBP patients in the emergency department.\"},{\"question\":\"How were patients diagnosed with spontaneous bacterial peritonitis in the study?\",\"answer\":\"SBP diagnosis was confirmed by ascitic fluid leukocyte count greater than 250/mm3.\"},{\"question\":\"Which biomarker performed best for predicting in-hospital mortality?\",\"answer\":\"The blood urea nitrogen/albumin ratio (BAR) was the strongest predictor, outperforming both RAR and NLR, with the highest prognostic performance reported.\"}]","The Prognostic Value of Biomarkers in Patients Diagnosed with Spontaneous Bacterial Peritonitis | PDF",1790761672,33]