Core IM | Internal Medicine Podcast CORE IM podcast: Mind The Gap on Admission Paracentesis
Nov 1, 2017
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Diagnostic Paracentesis on Admission
- Perform diagnostic paracentesis on cirrhotic patients with ascites upon hospital admission.
- This is a class one, level b recommendation from the American Association for the Study of Liver Diseases (AASLD).
Understanding Recommendation Levels
- A level B recommendation means the decision is based on a single randomized trial or non-randomized studies.
- Level A requires multiple randomized controlled trials or meta-analyses.
Limitations of Clinical Judgment
- Clinical judgment alone is insufficient to rule out SBP in patients with ascites.
- A study showed physician clinical impression had a sensitivity of 76% and specificity of 34%.