Rashidi-Alavijeh Jassin, Nuruzade Nargiz, Frey Alexandra, Huessler Eva-Maria, Hörster Anne, Zeller Amos Cornelius, Schütte Andreas, Schmidt Hartmut, Willuweit Katharina, Lange Christian Markus
Department of Gastroenterology, Hepatology and Transplant Medicine, Medical Faculty, University of Duisburg-Essen, Duisburg, Germany.
Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, Duisburg, Germany.
JHEP Rep. 2023 Jan 28;5(4):100688. doi: 10.1016/j.jhepr.2023.100688. eCollection 2023 Apr.
BACKGROUND & AIMS: Anaemia is frequently observed in patients with cirrhosis and was identified as a predictor of adverse outcomes, such as increased mortality and occurrence of acute-on-chronic liver failure. To date, the possible effects of iron supplementation on these adverse outcomes are not well described. We therefore aimed to assess the role of iron supplementation in patients with cirrhosis and its capability to improve prognosis.
Laboratory diagnostics were performed in consecutive outpatients with cirrhosis admitted between July 2018 and December 2019 to the University Hospital Essen. Associations with transplant-free survival were assessed in regression models.
A total of 317 outpatients with cirrhosis were included, of whom 61 received a liver transplant (n = 19) or died (n = 42). In multivariate Cox regression analysis, male sex (hazard ratio [HR] = 3.33, 95% CI [1.59, 6.99], = 0.001), model for end-stage liver disease score (HR = 1.19, 95% CI [1.11, 1.27], <0.001) and the increase of haemoglobin levels within 6 months (ΔHb6) (HR = 0.72, 95% CI [0.63, 0.83], <0.001) were associated with transplant-free survival. Regarding the prediction of haemoglobin increase, intake of rifaximin (beta = 0.50, SD beta = 0.19, = 0.007) and iron supplementation (beta = 0.79, SD beta = 0.26, = 0.003) were significant predictors in multivariate analysis.
An increase of haemoglobin levels is associated with improvement of transplant-free survival in patients with cirrhosis. Because the prediction of haemoglobin increase significantly depends on rifaximin and iron supplementation, application of these two medications can have an important impact on the outcome of these patients.
Anaemia is very common in patients with cirrhosis and is known to be a predictor of negative outcomes, but little is known about the effect of iron substitution in these individuals. In our cohort, increase of haemoglobin levels improved transplant-free survival of patients with cirrhosis. The increase of haemoglobin levels was mainly induced by iron supplementation and was even stronger in the case of concomitant use of iron and rifaximin.
UME-ID-10042.
贫血在肝硬化患者中很常见，并且被确定为不良结局的预测指标，如死亡率增加和慢加急性肝衰竭的发生。迄今为止，铁补充剂对这些不良结局的可能影响尚未得到充分描述。因此，我们旨在评估铁补充剂在肝硬化患者中的作用及其改善预后的能力。
对2018年7月至2019年12月间埃森大学医院收治的连续性肝硬化门诊患者进行实验室诊断。在回归模型中评估与无移植生存期的相关性。
共纳入317例肝硬化门诊患者，其中61例接受了肝移植（n = 19）或死亡（n = 42）。在多因素Cox回归分析中，男性（风险比[HR]=3.33，95%置信区间[1.59, 6.99]，P = 0.001）、终末期肝病模型评分（HR = 1.19，95%置信区间[1.11, 1.27]，P<0.001）以及6个月内血红蛋白水平的升高（ΔHb6）（HR = 0.72，95%置信区间[0.63, 0.83]，P<0.001）与无移植生存期相关。关于血红蛋白升高的预测，利福昔明的摄入（β = 0.50，标准误β = 0.19，P = 0.007）和铁补充剂（β = 0.79，标准误β = 0.26，P = 0.003）在多因素分析中是显著的预测指标。
血红蛋白水平的升高与肝硬化患者无移植生存期的改善相关。由于血红蛋白升高的预测显著依赖于利福昔明和铁补充剂，这两种药物的应用可能对这些患者的结局产生重要影响。
贫血在肝硬化患者中非常常见，并且已知是不良结局的预测指标，但关于这些个体中铁替代的影响知之甚少。在我们的队列中，血红蛋白水平的升高改善了肝硬化患者的无移植生存期。血红蛋白水平的升高主要由铁补充剂诱导，在同时使用铁和利福昔明的情况下作用更强。
UME-ID-10042。
