Development and internal validation of the SCAN score: A pragmatic bedside tool for early prediction of spontaneous bacterial peritonitis in patients with cirrhosis and ascites
Clinical and Experimental Hepatology, cilt.12, sa.1, ss.62-69, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 12 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.5114/ceh.2026.160517
- Dergi Adı: Clinical and Experimental Hepatology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
- Sayfa Sayıları: ss.62-69
- Anahtar Kelimeler: liver cirrhosis, ascites, spontaneous bacterial peritonitis, prediction model, risk stratification.
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim of the study: Delays in diagnostic paracentesis for suspected spontaneous bacterial peritonitis (SBP) contribute to preventable mortality in cirrhosis. This study aimed to develop and internally validate a pragmatic bedside score using routinely available admission variables to stratify the risk of SBP at hospital presentation. Material and methods: In this retrospective single-center cohort study, 1,312 consecutive adults with cirrhosis and ascites admitted between January 2020 and January 2025 were screened. A total of 1,000 unique patients met the eligibility criteria and were randomly divided into derivation (n = 700) and validation (n = 300) cohorts. SBP was defned as an ascitic polymorphonuclear leukocyte count ≥ 250/mm3. Multivariable logistic regression was used to identify independent predictors, which were incorporated into a four-component bedside score (SCAN: serum sodium, C-reactive protein, age, and neutrophil-to-lymphocyte ratio). Model discrimination and calibration were assessed. Results: Spontaneous bacterial peritonitis was diagnosed in 185 patients (18.5%). In the validation cohort, the SCAN score demonstrated good discriminatory performance (AUROC 0.91, 95% CI: 0.87-0.94) and acceptable calibration (slope 0.96, Brier score 0.06). The probability of SBP increased progressively from 2.2% at a score of 0 to 75.0% at scores of 5-6. A prespecifed cut-of of ≥ 3 points yielded a sensitivity of 88.1% and a specifcity of 91.7%. Conclusions: The SCAN score is a simple bedside tool that stratifes the risk of spontaneous bacterial peritonitis using routine admission variables. It may assist clinicians in prioritizing timely diagnostic evaluation, complementing guideline-recommended management. Prospective multicenter validation studies are warranted.