Proton Pump Inhibitor Therapy Increases the Risk of Spontaneous Bacterial Peritonitis in Patients with HBV-Related Acute-on-Chronic Liver Failure,Advances in Therapy

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Proton Pump Inhibitor Therapy Increases the Risk of Spontaneous Bacterial Peritonitis in Patients with HBV-Related Acute-on-Chronic Liver Failure
Advances in Therapy ( IF 3.4 ) Pub Date : 2021-07-25 , DOI: 10.1007/s12325-021-01844-1
Meng Zhang ₁ , Xin Xu ₁ , Wei Liu ₁ , Zhongwei Zhang ₁ , Qiuyu Cheng ₁ , Zhongyuan Yang ₁ , Tingting Liu ₁ , Yunhui Liu ₁ , Qin Ning ₁ , Tao Chen ₁ , Junying Qi ₁

Affiliation

Introduction

Spontaneous bacterial peritonitis (SBP) is a common infection in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). SBP significantly increases the mortality rate and medical costs. The association between proton pump inhibitor (PPI) use and SBP remains unclear. We conducted a retrospective study to investigate the association between PPI use and SBP in patients with HBV-related ACLF and to explore the risk factors for SBP.

Methods

We compared the SBP incidence between the PPI and non-PPI groups before and after propensity score matching and explored the association between the duration and type of PPI and SBP occurrence. Risk factors for SBP occurrence were determined by univariate and multivariate logistic regression analysis.

Results

The SBP incidence was higher in the PPI group than in the non-PPI group before and after propensity score matching. The SBP incidence increased for elevated MELD scores in PPI users. There was a similar SBP incidence in both different types and durations of PPI users. MELD score, old age, male sex, and high WBC count were significant independent risk factors for SBP in PPI users with HBV-related ACLF in the hospital.

Conclusions

PPI therapy increases the risk of SBP development in patients with HBV-related ACLF. MELD score, old age, male sex, and high WBC count could serve as predictors of SBP in PPI users. Caution should be taken regarding PPI use, especially for patients with MELD scores > 30.

中文翻译：

质子泵抑制剂治疗会增加 HBV 相关急慢性肝衰竭患者发生自发性细菌性腹膜炎的风险

介绍

自发性细菌性腹膜炎 (SBP) 是乙型肝炎病毒 (HBV) 相关的慢性肝衰竭 (ACLF) 患者的常见感染。SBP 显着增加死亡率和医疗费用。质子泵抑制剂 (PPI) 的使用与 SBP 之间的关联仍不清楚。我们进行了一项回顾性研究，以调查 HBV 相关 ACLF 患者使用 PPI 与 SBP 之间的关联，并探讨 SBP 的危险因素。

方法

我们比较了倾向评分匹配前后 PPI 和非 PPI 组之间的 SBP 发生率，并探讨了 PPI 的持续时间和类型与 SBP 发生之间的关联。SBP 发生的危险因素通过单变量和多变量逻辑回归分析确定。

结果

在倾向评分匹配前后，PPI组的SBP发生率高于非PPI组。PPI 使用者 MELD 评分升高时，SBP 发生率增加。不同类型和持续时间的 PPI 使用者的 SBP 发生率相似。MELD 评分、高龄、男性和高 WBC 计数是医院内患有 HBV 相关 ACLF 的 PPI 使用者 SBP 的显着独立危险因素。