Long‐term albumin administration in patients with cirrhosis and ascites: A meta‐analysis of randomized controlled trials
Background and Aim Ascites is a common complication of cirrhosis, and it is associated with increased mortality. The aim of this study was to evaluate the efficacy of long‐term albumin administration in decreasing mortality and other complications of patients with cirrhosis and ascites. Methods A sy...
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| Published in: | Journal of gastroenterology and hepatology Vol. 36; no. 3; pp. 609 - 617 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Australia
Wiley Subscription Services, Inc
01-03-2021
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background and Aim
Ascites is a common complication of cirrhosis, and it is associated with increased mortality. The aim of this study was to evaluate the efficacy of long‐term albumin administration in decreasing mortality and other complications of patients with cirrhosis and ascites.
Methods
A systematic review was performed using MEDLINE and Embase databases. Randomized controlled trials evaluating long‐term albumin administration in patients with cirrhosis and ascites were considered eligible, as long as at least one of the following outcomes was evaluated: mortality, recurrence of ascites/need for paracentesis, refractory ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, gastrointestinal bleeding, or adverse events. Meta‐analysis was performed using the random‐effects model, through the Mantel–Haenszel method. The study protocol was registered at PROSPERO platform (CRD42019130078).
Results
The literature search yielded 1517 references. Five randomized controlled trials fulfilled the selection criteria and were included in this meta‐analysis, involving 716 individuals. Patients receiving long‐term albumin had significantly lower risk of recurrence of ascites/need for paracentesis when compared with controls (risk ratio = 0.56, 95% confidence interval = 0.48–0.67, P < 0.00001). There was no evidence of significant difference between the long‐term albumin and control groups regarding mortality, refractory ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, gastrointestinal bleeding, or adverse events.
Conclusions
Long‐term albumin administration in patients with cirrhosis and ascites decreases recurrence of ascites/need for paracentesis. At this point, there is no evidence of significant benefits of long‐term albumin administration regarding mortality or other complications of cirrhosis. |
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| Bibliography: | None. Declaration of conflict of interest None of the authors has any personal or financial disclosure regarding this paper. There are no conflicts of interest to declare. Financial support ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| ISSN: | 0815-9319 1440-1746 |
| DOI: | 10.1111/jgh.15253 |