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Research Paper|Volume 11, Issue 19|pp 8502—8525

Albumin infusion may decrease the incidence and severity of overt hepatic encephalopathy in liver cirrhosis

Zhaohui Bai1,2, Mauro Bernardi3, Eric M. Yoshida4, Hongyu Li1, Xiaozhong Guo1, Nahum Méndez-Sánchez5, Yingying Li1, Ran Wang1, Jiao Deng6, Xingshun Qi1
  • 1Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, P.R. China
  • 2Postgraduate College, Shenyang Pharmaceutical University, Shenyang, P.R. China
  • 3Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
  • 4Division of Gastroenterology, Vancouver General Hospital, Vancouver, British Columbia, Canada
  • 5Liver Research Unit, Medica Sur Clinic and Foundation and Faculty of Medicine, National Autonomous University of Mexico, Mexico
  • 6Department of Pharmacology, General Hospital of Northern Theater Command, (formerly called General Hospital of Shenyang Military Area), Shenyang, P.R. China
Received: August 9, 2019Accepted: September 22, 2019Published: October 8, 2019
https://doi.org/10.18632/aging.102335

Copyright © 2019 Bai et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: The role of human albumin infusion for the prevention and treatment of overt hepatic encephalopathy (HE) in liver cirrhosis remains unclear. Results: Among the 708 patients without pre-existing overt HE, albumin infusion significantly decreased the incidence of overt HE (4.20% versus 12.70%, P<0.001) and in-hospital mortality (1.70% versus 5.40%, P=0.008). Among the 182 patients with overt HE at admission or during hospitalization, albumin infusion significantly improved overt HE (84.60% versus 68.10%, P=0.009) and decreased in-hospital mortality (7.70% versus 19.80%, P=0.018). Meta-analysis of 6 studies found that albumin infusion might decrease the risk of overt HE (OR=1.63, P=0.07), but the difference was not statistically significant. Meta-analysis of 3 studies found that albumin infusion significantly improved overt HE (OR=2.40, P=0.04). Conclusions: Based on the results of our retrospective study and meta-analysis, albumin infusion might prevent from the occurrence of overt HE and improve the severity of overt HE in cirrhosis. Our retrospective study also suggested that albumin infusion improved the outcomes of cirrhotic patients regardless of overt HE. Methods: Cirrhotic patients consecutively admitted between January 2010 and June 2014 were considered in a retrospective study. A 1:1 propensity score matching analysis was performed. Additionally, publications regarding albumin infusion for the management of overt HE were systematically searched. Meta-analyses were performed by random-effect model. Odds ratio (OR) was calculated.