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The 2012 American Association for the Study of Liver Diseases guideline (recommendation 26) recommends diagnostic paracentesis in all patients who are hospitalized with cirrhosis and ascites to evaluate for spontaneous bacterial peritonitis (SBP). To evaluate whether timing of paracentesis affects outcomes, researchers used an Agency for Healthcare Research and Quality database of all hospital discharges from 3 states to identify 75,000 adult patients with cirrhosis and ascites on admission who underwent paracentesis. About half of patients with cirrhosis and ascites on admission did not undergo paracentesis and were excluded from the study cohort.
Only 58% of the study cohort underwent early paracentesis (i.e., performed within 24 hours of …