PMID- 27139916
OWN - NLM
STAT- MEDLINE
DCOM- 20170623
LR  - 20220317
IS  - 1879-0828 (Electronic)
IS  - 0953-6205 (Linking)
VI  - 32
DP  - 2016 Jul
TI  - Impact of long-term gastric acid suppression on spontaneous bacterial peritonitis 
      in patients with advanced decompensated liver cirrhosis.
PG  - 91-5
LID - S0953-6205(16)30085-1 [pii]
LID - 10.1016/j.ejim.2016.04.016 [doi]
AB  - OBJECTIVE: Recent studies have presented conflicting results on the association 
      between gastric acid suppression and spontaneous bacterial peritonitis (SBP). The 
      long-term effects of gastric acid suppression on SBP in cirrhotic patients remain 
      unclear. This study evaluated the risk of SBP in advanced decompensated cirrhotic 
      patients with long-term gastric acid suppression. METHODS: Using the Taiwan 
      National Health Insurance Research Database, we identified 4788 patients with 
      decompensated cirrhosis from 1998 to 2011. The SBP incidence rate was compared 
      among proton pump inhibitor (PPI), H2-receptor antagonist (H2RA), and control 
      cohorts. Multivariate Cox proportional hazards regressions analysis was conducted 
      to confirm the association between gastric acid suppression and SBP. RESULTS: 
      Totally, 4788 patients were analyzed: 1870 in the PPI cohort, 1728 in the H2RA 
      cohort, and 1190 in the control cohort. The overall incidences of SBP were 16.8, 
      11.9, and 9.80 per 1000 person-years in the PPI, H2RA, and control cohorts, 
      respectively. The adjusted hazard ratio (aHR) of SBP during the follow-up period 
      was 1.16- (95% confidence interval [CI], 0.72-1.86) and 1.00-fold (95% CI, 
      0.63-1.57) higher in the PPI and H2RA cohorts, respectively, than in the control 
      cohort; the result was non-significant. Compared with the control cohort, 
      patients with >180days of PPI therapy had significantly higher risks of SBP, with 
      an aHR of 2.28 (95% CI, 1.37-3.78). CONCLUSIONS: Long-term PPI use is associated 
      with a high risk of SBP in advanced decompensated cirrhotic patients. 
      Well-designed prospective studies are necessary to evaluate the safety of 
      long-term PPI use in such patients.
CI  - Copyright (c) 2016 European Federation of Internal Medicine. Published by Elsevier 
      B.V. All rights reserved.
FAU - Huang, Kuang-Wei
AU  - Huang KW
AD  - Division of Gastroenterology, Department of Internal Medicine, Taipei Beitou 
      Health Management Hospital, Taipei, Taiwan; Division of Gastroenterology and 
      Hepatology, Department of Internal Medicine, School of Medicine, College of 
      Medicine, Taipei Medical University, Taipei, Taiwan.
FAU - Kuan, Yi-Chun
AU  - Kuan YC
AD  - Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New 
      Taipei City, Taiwan; Department of Neurology, School of Medicine, College of 
      Medicine, Taipei Medical University, Taipei, Taiwan.
FAU - Luo, Jiing-Chyuan
AU  - Luo JC
AD  - Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans 
      General Hospital, Taipei, Taiwan.
FAU - Lin, Cheng-Li
AU  - Lin CL
AD  - Management Office for Health Data, China Medical University Hospital, Taichung, 
      Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
FAU - Liang, Ji-An
AU  - Liang JA
AD  - Graduate Institute of Clinical Medical Science and School of Medicine, College of 
      Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan; 
      Department of Radiation Oncology, China Medical University Hospital, Taichung, 
      Taiwan.
FAU - Kao, Chia-Hung
AU  - Kao CH
AD  - Graduate Institute of Clinical Medical Science and School of Medicine, College of 
      Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan; 
      Department of Nuclear Medicine and PET Center, China Medical University Hospital, 
      Taichung, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20160429
PL  - Netherlands
TA  - Eur J Intern Med
JT  - European journal of internal medicine
JID - 9003220
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Bacterial Infections/*epidemiology
MH  - Case-Control Studies
MH  - Databases, Factual
MH  - Female
MH  - Histamine H2 Antagonists/*therapeutic use
MH  - Humans
MH  - Incidence
MH  - Liver Cirrhosis/*epidemiology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Peritonitis/*epidemiology
MH  - Proportional Hazards Models
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Taiwan/epidemiology
OTO - NOTNLM
OT  - Cirrhotic
OT  - Gastric acid suppression
OT  - National Health Insurance Research Database
OT  - Proton pump inhibitor (PPI)
OT  - Spontaneous bacterial peritonitis
EDAT- 2016/05/04 06:00
MHDA- 2017/06/24 06:00
CRDT- 2016/05/04 06:00
PHST- 2016/02/05 00:00 [received]
PHST- 2016/03/25 00:00 [revised]
PHST- 2016/04/15 00:00 [accepted]
PHST- 2016/05/04 06:00 [entrez]
PHST- 2016/05/04 06:00 [pubmed]
PHST- 2017/06/24 06:00 [medline]
AID - S0953-6205(16)30085-1 [pii]
AID - 10.1016/j.ejim.2016.04.016 [doi]
PST - ppublish
SO  - Eur J Intern Med. 2016 Jul;32:91-5. doi: 10.1016/j.ejim.2016.04.016. Epub 2016 
      Apr 29.