Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2022  |  Volume : 28  |  Issue : 2  |  Page : 108-114

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


1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung; Division of Gastroenterology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
3 Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei; Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital; Institute of Biomedical Sciences, College of Science, National Sun Yat-sen University, Kaohsiung, Taiwan
4 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
5 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei; Institute of Biomedical Sciences, College of Science, National Sun Yat-sen University, Kaohsiung, Taiwan

Correspondence Address:
Dr. Wen-Chi Chen
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st. Rd., Kaohsiung City 813
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.sjg_586_21

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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.


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