Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis.

Fernández, Javier; Angeli, P; Trebicka, J; Merli, M; Gustot, T; Alessandria, C; Aagaard, N K; De Gottardi, Andrea; 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; ... (2020). Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis. Clinical gastroenterology and hepatology, 18(4), 963-973.e14. Elsevier 10.1016/j.cgh.2019.07.055

[img] Text
1-s2.0-S1542356519308444-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

UniBE Contributor:

De Gottardi, Andrea

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1542-3565

Publisher:

Elsevier

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

08 Jan 2020 11:14

Last Modified:

22 Mar 2020 01:32

Publisher DOI:

10.1016/j.cgh.2019.07.055

PubMed ID:

31394283

Uncontrolled Keywords:

Acute-on-Chronic Liver Failure Immune-Modulation Mortality Nosocomial Infections

BORIS DOI:

10.7892/boris.137308

URI:

https://boris.unibe.ch/id/eprint/137308

Actions (login required)

Edit item Edit item
Provide Feedback