Albumin for cirrhotic patients with extraperitoneal infections: A meta‐analysis

• Published in: Journal of gastroenterology and hepatology Vol. 34; no. 12; pp. 2071 - 2076
• Main Authors: Leão, Gabriel Stefani, John Neto, Guilherme, Jotz, Raquel de Freitas, Mattos, Angelo Alves de, Mattos, Ângelo Zambam de
• Format: Journal Article
• Language: English
• Published: Australia 01-12-2019
• Subjects: Albumin; Cirrhosis; Extraperitoneal; Infection; Meta‐analysis; Infection; Albumin; Cirrhosis; Extraperitoneal; Meta-analysis
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.14791

Background and Aim
Bacterial infections are among the main causes of death in patients with cirrhosis. While there are unquestionable benefits of using albumin in patients with spontaneous bacterial peritonitis, the benefits of albumin are controversial for those with extraperitoneal infections. The aim was to compare the use of albumin associated to antibiotics and antibiotics alone in cirrhotic patients with extraperitoneal infections.
Methods
A systematic review was performed using MEDLINE and Embase databases. Randomized controlled trials comparing albumin associated to antibiotics and antibiotics alone in cirrhotic patients with extraperitoneal infections were considered eligible, as long as at least one of the following outcomes was evaluated: mortality and renal dysfunction. Meta‐analysis was performed using the random effects model, through the Mantel–Haenszel method. The study protocol was registered at PROSPERO platform (CRD42018107191).
Results
The literature search yielded 812 references. Three randomized controlled trials fulfilled the selection criteria and were included in this meta‐analysis. There was no evidence of significant difference between the groups regarding mortality in 30 days (risk ratio [RR] = 1.62, 95% confidence interval [CI]: 0.92–2.84, P = 0.09, I2 = 0%) or in 90 days (RR = 1.27, 95% CI: 0.89–1.83, P = 0.19, I2 = 0%). Regarding renal dysfunction, there was also no evidence of significant difference between the groups (RR = 0.55, 95% CI: 0.25–1.19, P = 0.13, I2 = 0%).
Conclusion
There is no evidence of significant benefits of using albumin for cirrhotic patients with extraperitoneal infections regarding mortality or renal dysfunction.