Tsung-Hsing Hung1, Chih-Wei Tseng1, Hsing-Feng Lee1, Chih-Chun Tsai2, Chen-Chi Tsai3. 1. Division of Gastroenterology. Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan. 2. Department of Mathematics, Tamkang University, Tamsui, Taiwan. 3. School of Medicine, Tzu Chi University, Hualien, Taiwan.
Abstract
INTRODUCTION AND AIM: Spontaneous bacterial peritonitis (SBP) is a life-threatening infection in patients with cirrhosis. However, it is unknown whether patients with SBP and cirrhosis who do not have active gastrointestinal bleeding have a poorer prognosis if treated with proton pump inhibitors (PPI). MATERIAL AND METHODS: We used the Taiwan National Health Insurance Database to identify 858 patients with SBP and cirrhosis who were administered PPIs and hospitalized between January 1, 2010, and December 31, 2013. One-to-two propensity score matching was performed to select a comparison group based on age, gender, and comorbidities. All patients obtained follow-up for 1 year. RESULTS: The overall 30-day, 90-day, and 1-year mortality was 27.9%, 49.0%, and 73.7%, respectively, in the PPI group and 25.6%, 43.8%, and 67.2%, respectively, in the non-PPI group. After adjusting the Cox regression model for age, gender, and comorbidities, the hazard ratios for PPIs regarding 30-day, 30- to 90-day, and 90-day to 1-year mortality were 1.074 (95% CI 0.917-1.257, P = 0.377), 1.390 (95% CI 1.154-1.673, P = 0.001), and 1.297 (95% CI 1.099- 1.531, P = 0.002), respectively. CONCLUSIONS: PPIs did not increase the short-term mortality of patients with SBP and cirrosis who did not have active gastrointestinal bleeding, but PPIs increased the long-term mortality risk. For these patients, physicians should discontinue PPIs as early as possible.
INTRODUCTION AND AIM: Spontaneous bacterial peritonitis (SBP) is a life-threatening infection in patients with cirrhosis. However, it is unknown whether patients with SBP and cirrhosis who do not have active gastrointestinal bleeding have a poorer prognosis if treated with proton pump inhibitors (PPI). MATERIAL AND METHODS: We used the Taiwan National Health Insurance Database to identify 858 patients with SBP and cirrhosis who were administered PPIs and hospitalized between January 1, 2010, and December 31, 2013. One-to-two propensity score matching was performed to select a comparison group based on age, gender, and comorbidities. All patients obtained follow-up for 1 year. RESULTS: The overall 30-day, 90-day, and 1-year mortality was 27.9%, 49.0%, and 73.7%, respectively, in the PPI group and 25.6%, 43.8%, and 67.2%, respectively, in the non-PPI group. After adjusting the Cox regression model for age, gender, and comorbidities, the hazard ratios for PPIs regarding 30-day, 30- to 90-day, and 90-day to 1-year mortality were 1.074 (95% CI 0.917-1.257, P = 0.377), 1.390 (95% CI 1.154-1.673, P = 0.001), and 1.297 (95% CI 1.099- 1.531, P = 0.002), respectively. CONCLUSIONS: PPIs did not increase the short-term mortality of patients with SBP and cirrosis who did not have active gastrointestinal bleeding, but PPIs increased the long-term mortality risk. For these patients, physicians should discontinue PPIs as early as possible.
Authors: Chun-Han Lo; Peiyun Ni; Yan Yan; Wenjie Ma; Amit D Joshi; Long H Nguyen; Raaj S Mehta; Paul Lochhead; Mingyang Song; Gary C Curhan; Yin Cao; Andrew T Chan Journal: Gastroenterology Date: 2022-07-01 Impact factor: 33.883
Authors: Dimitrios N Samonakis; Nikolaos Gatselis; Aristea Bellou; Dimitra Sifaki-Pistolla; Maria Mela; George Demetriou; Evangelos Thalassinos; Eirini I Rigopoulou; Polyxeni Kevrekidou; Ioannis Tziortziotis; Kalliopi Azariadi; Melina Kavousanaki; Emmanuel Digenakis; Themistoklis Vassiliadis; Elias A Kouroumalis; George N Dalekos Journal: Ann Gastroenterol Date: 2021-11-10