Propranolol use in patients with cirrhosis and refractory ascites: A nationwide study.

Journal: Saudi Journal Of Gastroenterology : Official Journal Of The Saudi Gastroenterology Association
Treatment Used: Propranolol
Number of Patients: 3576
Published:
MediFind Summary

Summary: This study evaluated the use of propranolol in the treatment of patients with cirrhosis with refractory ascites (fluid in abdomen).

Conclusion: In patients with cirrhosis with refractory ascites (fluid in abdomen), treatment with propranolol was linked to decreased mortality.

Abstract

Background: The impact of propranolol on patients with cirrhosis and refractory ascites is controversial. We conducted a nationwide longitudinal cohort study to compare the survival between patients with cirrhosis and refractory ascites, with and without using propranolol.

Methods: Data of patients with cirrhosis and refractory ascites using propranolol, and controls matched by age and gender, were extracted from The National Health Insurance Research Database of Taiwan. The baseline demographic characteristics were compared between groups. Cox regression analysis was used to examine the predictors of mortality.

Results: In this study, 1788 patients were enrolled in each group; 1304 patients (72.9%) in the propranolol group and 1445 patients (80.8%) in the control group died (P < 0.001). The mean survival was 34.3 ± 31.2 months in the propranolol group and 20.8 ± 26.6 months in the control group (P < 0.001). Propranolol (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.55-0.64, P < 0.001), statins (HR: 0.43, 95% CI: 0.34-0.56, P < 0.001), age (HR: 1.02, 95% CI: 1.01-1.02, P < 0.001), and diabetes mellitus (HR: 1.14, 95% CI: 1.05-1.24, P = 0.002) were the independent predictors for mortality.

Conclusions: Use of propanolol was associated with reduced mortality, compared with controls, in this nationwide cohort of patients with cirrhosis and refractory ascites.

Authors
Yen-chun Chen, Yun-da Li, Chia-ming Lu, Wei-chun Huang, Sung-shuo Kao, Wen-chi Chen

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