Risk Factors for Hepatic Hydrothorax in Cirrhosis Patients with Ascites - A Clinical Cohort Study
| Autor: | Peter Uhd Jepsen, Hendrik Vilstrup, Thomas Deleuran, Hugh Watson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Cirrhosis Physiology Pleural effusion Adrenergic beta-Antagonists Ascites/etiology Gastroenterology Cohort Studies 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Liver Cirrhosis/complications Risk Factors Internal medicine Ascites Paracentesis Diabetes Mellitus Medicine Humans Portal hypertension Hepatic encephalopathy Hydrothorax/etiology medicine.diagnostic_test business.industry Diabetes Bilirubin medicine.disease Satavaptan Hepatic hydrothorax chemistry 030220 oncology & carcinogenesis Spironolactone 030211 gastroenterology & hepatology Non-selective beta-blockers medicine.symptom business |
| Zdroj: | Deleuran, T, Watson, H, Vilstrup, H & Jepsen, P 2022, ' Risk Factors for Hepatic Hydrothorax in Cirrhosis Patients with Ascites-A Clinical Cohort Study ', Digestive Diseases and Sciences, vol. 67, no. 7, pp. 3395–3401 . https://doi.org/10.1007/s10620-021-07134-8 Deleuran, T, Watson, H, Vilstrup, H & Jepsen, P 2022, ' Risk Factors for Hepatic Hydrothorax in Cirrhosis Patients with Ascites-A Clinical Cohort Study ', Digestive Diseases and Sciences, vol. 67, no. 7, pp. 3395-3401 . https://doi.org/10.1007/s10620-021-07134-8 |
| DOI: | 10.1007/s10620-021-07134-8 |
| Popis: | BACKGROUND: The risk factors for hepatic hydrothorax are unknown.METHODS: We used data from three randomized trials of satavaptan treatment in patients with cirrhosis and ascites followed for up to 1 year. We excluded patients with previous hepatic hydrothorax or other causes for pleural effusion. The candidate risk factors were age, sex, heart rate, mean arterial pressure, diuretic-resistant ascites, a recurrent need for paracentesis, diabetes, hepatic encephalopathy, International Normalized Ratio, creatinine, bilirubin, albumin, sodium, platelet count, use of non-selective beta-blockers (NSBBs), spironolactone, furosemide, proton pump inhibitors, and insulin. We identified risk factors using a Fine and Gray regression model and backward selection. We reported subdistribution hazard ratios (sHR) for hepatic hydrothorax. Death without hepatic hydrothorax was a competing risk.RESULTS: Our study included 942 patients, of whom 41 developed hepatic hydrothorax and 65 died without having developed it. A recurrent need for paracentesis (sHR: 2.55, 95% CI: 1.28-5.08), bilirubin (sHR: 1.18 per 10 µmol/l increase, 95% CI: 1.09-1.28), diabetes (sHR: 2.49, 95% CI: 1.30-4.77) and non-use of non-selective beta-blockers (sHR: 2.27, 95% CI: 1.13-4.53) were risk factors for hepatic hydrothorax. Development of hepatic hydrothorax was associated with a high mortality-hazard ratio of 4.35 (95% CI: 2.76-6.97).CONCLUSIONS: In patients with cirrhosis and ascites, risk factors for hepatic hydrothorax were a recurrent need for paracentesis, a high bilirubin, diabetes and non-use of NSBBs. Among these patients with cirrhosis and ascites, development of hepatic hydrothorax increased mortality fourfold. |
| Databáze: | OpenAIRE |
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