Risk Factors for Hepatic Hydrothorax in Cirrhosis Patients with Ascites - A Clinical Cohort Study

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..

BACKGROUND: The risk factors for hepatic hydrothorax are unknown.

METHODS: We used data from three randomized trials of satavaptan treatment in patients with cirrhosis and ascites followed for up to 1 year. We excluded patients with previous hepatic hydrothorax or other causes for pleural effusion. The candidate risk factors were age, sex, heart rate, mean arterial pressure, diuretic-resistant ascites, a recurrent need for paracentesis, diabetes, hepatic encephalopathy, International Normalized Ratio, creatinine, bilirubin, albumin, sodium, platelet count, use of non-selective beta-blockers (NSBBs), spironolactone, furosemide, proton pump inhibitors, and insulin. We identified risk factors using a Fine and Gray regression model and backward selection. We reported subdistribution hazard ratios (sHR) for hepatic hydrothorax. Death without hepatic hydrothorax was a competing risk.

RESULTS: Our study included 942 patients, of whom 41 developed hepatic hydrothorax and 65 died without having developed it. A recurrent need for paracentesis (sHR: 2.55, 95% CI: 1.28-5.08), bilirubin (sHR: 1.18 per 10 µmol/l increase, 95% CI: 1.09-1.28), diabetes (sHR: 2.49, 95% CI: 1.30-4.77) and non-use of non-selective beta-blockers (sHR: 2.27, 95% CI: 1.13-4.53) were risk factors for hepatic hydrothorax. Development of hepatic hydrothorax was associated with a high mortality-hazard ratio of 4.35 (95% CI: 2.76-6.97).

CONCLUSIONS: In patients with cirrhosis and ascites, risk factors for hepatic hydrothorax were a recurrent need for paracentesis, a high bilirubin, diabetes and non-use of NSBBs. Among these patients with cirrhosis and ascites, development of hepatic hydrothorax increased mortality fourfold.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:67

Enthalten in:

Digestive diseases and sciences - 67(2022), 7 vom: 11. Juli, Seite 3395-3401

Sprache:

Englisch

Beteiligte Personen:

Deleuran, Thomas [VerfasserIn]
Watson, Hugh [VerfasserIn]
Vilstrup, Hendrik [VerfasserIn]
Jepsen, Peter [VerfasserIn]

Links:

Volltext

Themen:

Adrenergic beta-Antagonists
Ascites
Bilirubin
Cirrhosis
Diabetes
Hepatic hydrothorax
Journal Article
Non-selective beta-blockers
Portal hypertension
RFM9X3LJ49

Anmerkungen:

Date Completed 29.06.2022

Date Revised 17.08.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s10620-021-07134-8

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM327380330