Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis
| Autor: | Christian Jansen, Paolo Angeli, Manuela Merli, Francesco Salerno, Tania M. Welzel, Vicente Arroyo, Jonel Trebicka, Rita Garcia, Andrea De Gottardi, Agustín Albillos, Alex Amoros, Richard Moreau, Germán Soriano, Cristina Sanchez, Joan Clària, Alexander L. Gerbes, Fatima Aziz, Mireya Arteaga, François Durand, Elisabet Garcia, Daniela Campion, Thierry Gustot, Barbara Lattanzi, Verónica Prado, Filippo Morando, Victor Vargas, Marco Pavesi, Christophe Moreno, María Hernández-Tejero, Rafael Bañares, Henning Grønbæk, Rudolf E. Stauber, Niels Kristian Aagaard, Carlo Alessandria, Javier Fernández |
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| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
Cirrhosis Nosocomial Infections Antibiotics Communicable diseases Gastroenterology law.invention 0302 clinical medicine immune-modulation Randomized controlled trial Hepatorenal syndrome law Albúmines Gastro-entérologie 610 Medicine & health Acute-on-Chronic Liver Failure biology Immune-Modulation Mortality acute-on-chronic liver failure mortality nosocomial infections albumins humans liver cirrhosis bacterial infections peritonitis Bacterial Infections Hepatic cirrhosis 030220 oncology & carcinogenesis Anti-infective agents 030211 gastroenterology & hepatology medicine.medical_specialty Agents antiinfecciosos Cirrosi hepàtica medicine.drug_class Peritonitis 03 medical and health sciences Spontaneous bacterial peritonitis Internal medicine Albumins medicine Humans Intention-to-treat analysis Hepatology business.industry C-reactive protein Albumin Acute-On-Chronic Liver Failure Malalties infeccioses medicine.disease biology.protein business |
| Zdroj: | Clinical gastroenterology and hepatology, 18 (4 Fernández, J, Angeli, P, Trebicka, J, Merli, M, Gustot, T, Alessandria, C, Aagaard, N K, de Gottardi, A, Welzel, T M, Gerbes, A, Soriano, G, Vargas, V, Albillos, A, Salerno, F, Durand, F, Bañares, R, Stauber, R, Prado, V, Arteaga, M, Hernández-Tejero, M, Aziz, F, Morando, F, Jansen, C, Lattanzi, B, Moreno, C, Campion, D, Gronbaek, H, Garcia, R, Sánchez, C, García, E, Amorós, A, Pavesi, M, Clària, J, Moreau, R & Arroyo, V 2020, ' Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis ', Clinical Gastroenterology and Hepatology, vol. 18, no. 4, pp. 963-973.e14 . https://doi.org/10.1016/j.cgh.2019.07.055 Dipòsit Digital de la UB Universidad de Barcelona |
| ISSN: | 1542-7714 |
| DOI: | 10.1016/j.cgh.2019.07.055 |
| Popis: | Background & Aims: We performed a randomized trial to determine whether albumin should be administered to patients with infections unrelated to spontaneous bacterial peritonitis (SBP). Methods: We performed a multicenter, open-label trial in which 118 patients with cirrhosis, non-SBP infections, and additional risk factors for poor outcome were randomly assigned to receive antibiotics plus albumin (study group; n = 61) or antibiotics alone (control group; n = 57). The primary outcome was in-hospital mortality; secondary outcomes were effect of albumin on disease course. Results: There were no significant differences at baseline between groups in results from standard laboratory tests, serum markers of inflammation, circulatory dysfunction, or liver severity scores. However, the combined prevalence of acute on chronic liver failure (ACLF) and kidney dysfunction was significantly higher in the study group (44.3% vs 24.6% in the control group; P = .02), indicating greater baseline overall severity. There was no significant difference in the primary outcome between groups (13.1% in the study group vs 10.5% in the control group; P = .66). Circulatory and renal functions improved in only the study group. A significantly higher proportion of patients in the study group had resolution of ACLF (82.3% vs 33.3% in the control group; P = .03). A significantly lower proportion of patients in the study group developed nosocomial infections (6.6% vs 24.6% in the control group; P = .007). Conclusions: In a randomized trial of patients with advanced cirrhosis and non-SBP infections, in-hospital mortality was similar between those who received albumin plus antibiotics vs those who received only antibiotics (controls). However, patients given albumin were sicker at baseline and, during the follow-up period, a higher proportion had ACLF resolution and a lower proportion had nosocomial infections. ClinicalTrials.gov no: NCT02034279. SCOPUS: ar.j info:eu-repo/semantics/published |
| Databáze: | OpenAIRE |
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