Short-Term Proton Pump Inhibitor Use and Hepatic Encephalopathy Risk in Patients with Decompensated Cirrhosis

Objective: A window period of approximately 3–6 months is usually adopted in studies that evaluate hepatic encephalopathy (HE) risk in proton pump inhibitor (PPI) users. However, HE risk after short-term PPI exposure remains unclear. We explored the effect of short-term PPI exposure using a case-crossover study design. Design: Records of patients with decompensated cirrhosis who had received an HE diagnosis were retrieved from the National Health Insurance Research Database. PPI use rates were compared for case and control with window periods of 7, 14, and 28 days. The adjusted self-matched odds ratio (OR) and 95% confidence interval (CI) from a conditional logistic regression model were used to determine the association between PPI use and HE risk. Results: Overall, 13 195 patients were analyzed. The adjusted OR for HE risk after PPI exposure was 3.13 (95% CI = 2.33–4.20) for the 7-day window, 4.77 (95% CI = 3.81–5.98) for the 14-day window, and 5.60 (95% CI = 4.63–6.78) for the 28-day window. All PPI categories, except omeprazole and pantoprazole, were associated with an increased HE risk. Irrespective of other precipitating factors, such as recent gastrointestinal bleeding or infection, PPI significantly increased HE risk. Conclusion: Short-term PPI use is significantly associated with HE in patients with decompensated cirrhosis. Physicians should use PPI in these patients for appropriate indications, and carefully monitor signs of HE even after short-term exposure. Owing to the limitations of retrospective design in the current study, further study is warranted to confirm our findings.

Download Full-text

Proton pump inhibitor use is associated with increased rates of post-TIPS hepatic encephalopathy: Replication in an independent patient cohort

Clinical Imaging ◽

10.1016/j.clinimag.2021.04.034 ◽

2021 ◽

Vol 77 ◽

pp. 187-192

Author(s):

Rui Dai ◽

Alan A. Sag ◽

Jonathan G. Martin ◽

Nicholas T. Befera ◽

Waleska M. Pabon-Ramos ◽

...

Keyword(s):

Hepatic Encephalopathy ◽

Proton Pump Inhibitor ◽

Proton Pump ◽

Patient Cohort

Download Full-text

Effect of ambient fine particulates (PM2.5) on hospital admissions for respiratory and cardiovascular diseases in Wuhan, China

Respiratory Research ◽

10.1186/s12931-021-01731-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Zhan Ren ◽

Xingyuan Liu ◽

Tianyu Liu ◽

Dieyi Chen ◽

Kuizhuang Jiao ◽

...

Keyword(s):

Air Pollution ◽

Hospital Admission ◽

Hospital Admissions ◽

Conditional Logistic Regression ◽

Warm Season ◽

Central China ◽

Air Pollution Control ◽

Short Term ◽

Short Term Exposure ◽

Increased Risk

Abstract Background Positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of a megalopolis. In addition, most studies in China have used averaged data, which results in variations between monitoring and personal exposure values, creating an inherent and unavoidable type of measurement error. Methods This study was conducted in Wuhan, a megacity in central China with about 10.9 million people. Daily hospital admission records, from October 2016 to December 2018, were obtained from the Wuhan Information center of Health and Family Planning, which administrates all hospitals in Wuhan. Daily air pollution concentrations and weather variables in Wuhan during the study period were collected. We developed a land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposure to PM2.5. We also conducted stratification analyses by age, sex, and season. Results A total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 cardiovascular disease admissions and 159,365 respiratory disease admissions. Short-term exposure to PM2.5 was associated with an increased risk of a cardiorespiratory hospital admission. A 10 μg/m3 increase in PM2.5 (lag0–2 days) was associated with an increase in hospital admissions of 1.23% (95% CI 1.01–1.45%) and 1.95% (95% CI 1.63–2.27%) for cardiovascular and respiratory diseases, respectively. The elderly were at higher PM-induced risk. The associations appeared to be more evident in the cold season than in the warm season. Conclusions This study contributes evidence of short-term effects of PM2.5 on cardiorespiratory hospital admissions, which may be helpful for air pollution control and disease prevention in Wuhan.

Download Full-text

Proton pump inhibitor use is associated with an increased risk of hepatic encephalopathy in a large cohort of patients with cirrhosis

Journal of Hepatology ◽

10.1016/s0168-8278(20)31911-5 ◽

2020 ◽

Vol 73 ◽

pp. S729

Author(s):

Koos de Wit ◽

Thijs Kuipers ◽

Bert Baak ◽

Ulrich Beuers ◽

Bart Takkenberg

Keyword(s):

Hepatic Encephalopathy ◽

Proton Pump Inhibitor ◽

Proton Pump ◽

Large Cohort ◽

Increased Risk

Download Full-text

Proton Pump Inhibitor Therapy and Hepatic Encephalopathy Risk in Cirrhotic Patients: A Systematic Review with Meta-analysis

Clinical Drug Investigation ◽

10.1007/s40261-019-00810-8 ◽

2019 ◽

Vol 39 (9) ◽

pp. 847-856 ◽

Cited By ~ 1

Author(s):

Dawei Shi ◽

Ziye Zhou ◽

Ying Dai ◽

Xiaofeng Pan ◽

Qinqin Cao

Keyword(s):

Systematic Review ◽

Hepatic Encephalopathy ◽

Proton Pump Inhibitor ◽

Proton Pump ◽

Meta Analysis ◽

Proton Pump Inhibitor Therapy ◽

Inhibitor Therapy ◽

Cirrhotic Patients

Download Full-text

03:00 PM Abstract No. 169 Proton pump inhibitor use is a major risk factor for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2018.12.222 ◽

2019 ◽

Vol 30 (3) ◽

pp. S77-S78

Author(s):

J. Ronald ◽

D. Lewis ◽

T. Lee ◽

M. Konanur ◽

C. Ziegler ◽

...

Keyword(s):

Risk Factor ◽

Hepatic Encephalopathy ◽

Proton Pump Inhibitor ◽

Proton Pump ◽

Transjugular Intrahepatic Portosystemic Shunt ◽

Portosystemic Shunt ◽

Major Risk Factor ◽

Intrahepatic Portosystemic Shunt

Download Full-text

Proton pump inhibitor-related headaches: A nationwide population-based case-crossover study in Taiwan

Cephalalgia ◽

10.1177/0333102414535114 ◽

2014 ◽

Vol 35 (3) ◽

pp. 203-210 ◽

Cited By ~ 5

Author(s):

Jen-Feng Liang ◽

Yung-Tai Chen ◽

Jong-Ling Fuh ◽

Szu-Yuan Li ◽

Tzeng-Ji Chen ◽

...

Keyword(s):

Proton Pump Inhibitor ◽

Crossover Study ◽

Proton Pump ◽

Conditional Logistic Regression ◽

Population Based ◽

Female Patients ◽

Case Crossover ◽

Increased Risk ◽

Tension Type Headaches ◽

Acute Headache

Background Headaches resulting from proton pump inhibitor (PPI) use could cause discontinuation of PPI in as many as 40% of patients who experience such headaches. Previous studies focusing on acute headache risk from PPI use are rare and limited to clinical trials of a single PPI. Objectives To investigate the association between PPI use and headache with a nationwide population-based case-crossover study. Methods Records containing the first diagnosis of any headache, including migraine and tension-type headaches, were retrieved from Taiwan National Health Insurance Database (1998–2010). We compared the rates of PPI use for cases and controls during time windows of 7, 14, and 28 days. The adjusted self-matched odds ratios (ORs) and 95% confidence intervals (CIs) from a conditional logistic regression model were used to determine the association between PPI use and headache. Results Overall, 314,210 patients with an initial diagnosis of any headache during the study period were enrolled. The adjusted ORs for headache risk after PPI exposure were calculated for three time periods (within 7 days = 1.41, p = 0.002, 95% CI 1.14–1.74; within 14 days = 1.36, p < 0.001, 95% CI 1.16–1.59; within 28 days = 1.20, p = 0.002, 95% CI 1.07–1.35). Subgroup analyses showed female patients had an increased risk of headache. Among PPIs, lansoprazole and esomeprazole had the highest risks of headache incidence, which were similar to that of nitrates. Conclusion PPI usage is associated with an increased risk for acute headache. Female patients and use of lansoprazole or esomeprazole present the greatest risks of headache.

Download Full-text

Efficacy of Magnetic Sphincter Augmentation versus Nissen Fundoplication for Gastroesophageal Reflux Disease in Short Term: A Meta-Analysis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2017/9596342 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Ming-yu Chen ◽

Di-yu Huang ◽

Angela Wu ◽

Yi-bin Zhu ◽

He-pan Zhu ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Proton Pump Inhibitor ◽

Gastroesophageal Reflux ◽

Adverse Events ◽

Proton Pump ◽

Reflux Disease ◽

Operative Time ◽

Meta Analysis ◽

Magnetic Sphincter Augmentation ◽

Short Term

Background. The efficacy of Magnetic Sphincter Augmentation (MSA) and its outcomes for Gastroesophageal Reflux Disease (GERD) are uncertain. Therefore, we aimed to summarize and analyze the efficacy of two treatments for GERD.Methods. The meta-analysis search was performed, using four databases. All studies from 2005 to 2016 were included. Pooled effect was calculated using either the fixed or random effects model.Results. A total of 4 trials included 624 patients and aimed to evaluate the differences in proton-pump inhibitor use, complications, and adverse events. MSA had a shorter operative time (MSA and NF: RR = −18.80, 95% CI: −24.57 to −13.04, andP=0.001) and length of stay (RR = −14.21, 95% CI: −24.18 to −4.23, andP=0.005). Similar proton-pump inhibitor use, complication (P=0.19), and severe dysphagia for dilation were shown in both groups. Although there is no difference between the MSA and NF in the number of adverse events, the incidence of postoperative gas or bloating (RR = 0.71, 95% CI: 0.54–0.94, andP=0.02) showed significantly different results. However, there is no significant difference in ability to belch and ability to vomit.Conclusions. MSA can be recommended as an alternative treatment for GERD according to their short-term studies, especially in main-features of gas-bloating, due to shorter operative time and less complication of gas or bloating.

Download Full-text