Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/173530
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 Albúmines Malalties infeccioses Cirrosi hepàtica Anti-infective agents Albumins 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. ClinicalTrials.gov no: NCT02034279. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1016/j.cgh.2019.07.055 |
It is part of: | Clinical Gastroenterology and Hepatology, 2019, vol. 18, num. 4, p. 963-973 |
URI: | http://hdl.handle.net/2445/173530 |
Related resource: | https://doi.org/10.1016/j.cgh.2019.07.055 |
ISSN: | 1542-3565 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Biomedicina) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
698641.pdf | 1.56 MB | Adobe PDF | View/Open |
This item is licensed under a Creative Commons License