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Hospitalized patients with cirrhosis and ascites have high risk for spontaneous bacterial peritonitis (SBP), with as many as one third of episodes occurring asymptomatically. Hence, guidelines recommend diagnostic paracentesis in all patients hospitalized with cirrhosis and ascites, but they do not recommend specific timing of inpatient paracentesis (NEJM JW Gen Med Nov 1 2021 and Hepatology 2021; 74:1014).
In a meta-analysis of 7 observational studies (>78,000 patients), patients who underwent diagnostic paracentesis within 12 to 24 hours after admission had significantly better outcomes compared with patients who had more-delayed or no paracentesis, including lower rate of acute kidney injury (24% vs. 35%), shorter hospital length of stay …