ArticleWorld journal of clinical cases2022
Nonselective beta-blocker use is associated with increased hepatic encephalopathy-related readmissions in cirrhosis.
Article in World journal of clinical cases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Inpatient management of hepatic encephalopathy.Clinical liver diseaseReview
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundHepatic encephalopathy (HE) is a neurocognitive condition in cirrhosis leading to frequent hospitalizations. Nonselective beta-blockers (NSBBs) are the mainstay of pharmacologic treatment in cirrhotic patients. We hypothesized that since NSBBs decrease cardiac output and portal flow, the decreased metabolic filtering process of liver parenchyma may lead to increased HE-related hospitalizations.
aimTo evaluate the impact of NSBB administration on HE-related readmissions in cirrhotic patients.
methodsIn this retrospective cohort study, we included 393 patients admitted to Baylor University Medical Center for liver-related portal hypertension indications between January 2013 and July 2018. Independent predictors of the first HE-related readmissions were identified using Cox proportional hazards analysis. The cumulative incidence of the first HE-related readmissions between patients receiving NSBBs and not receiving NSBBs was examined using Fine-Gray modeling to account for the competing risk of death or liver transplantation.
resultsThe mean age was 58.1 ± 10.2 years and most patients fell into Child class C (49.1%) or B (43.8%). The median Model for End-Stage Liver Disease-Sodium score was 22 (IQR: 11). The cumulative incidence of the first HE-related readmissions was significantly higher in patients taking NSBBs compared to patients not receiving NSBBs (71.8%
conclusionNSBB use is independently associated with increased HE-related readmissions in patients with cirrhosis, regardless of liver disease severity.
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