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Title: Efficacy of Albumin Treatment for Patients with Cirrhosis and Infections Unrelated to Spontaneous Bacterial Peritonitis
Author: Fernández Gómez, Javier
Angeli, Paolo
Trebicka, Jonel
Merli, Manuela
Gustot, Thierry
Alessandria, Carlo
Aagaard, Niels Kristian
Gottardi, Andrea de
Welzel, Tania Mara
Gerbes, Alexander L.
Soriano Pastor, Germán
Vargas, Víctor
Albillos, Agustín
Salerno, Francesco
Durand, François
Bañares, Rafael
Stauber, Rudolf E.
Prado, Verónica
Arteaga López, Mireya
Hernández Tejero, María
Aziz, Fátima
Morando, Filippo
Jansen, Christian
Lattanzi, Barbara
Moreno, Christophe
Campion, Daniela
Gronbaek, Henning
García, Rita
Sánchez, Cristina
García, Elisabet
Amorós, Àlex
Pavesi, Marco
Clària i Enrich, Joan
Moreau, Richard
Arroyo, Vicente
Keywords: Agents antiinfecciosos
Malalties infeccioses
Cirrosi hepàtica
Anti-infective agents
Communicable diseases
Hepatic cirrhosis
Issue Date: 5-Aug-2019
Publisher: Elsevier
Abstract: 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. no: NCT02034279.
Note: Versió postprint del document publicat a:
It is part of: Clinical Gastroenterology and Hepatology, 2019, vol. 18, num. 4, p. 963-973
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ISSN: 1542-3565
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Biomedicina)

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