PDF(Pubmed)
Abstract：
UNASSIGNED: Recent findings suggest that cirrhotic patients on proton pump inhibitors (PPIs) are at a higher risk for developing spontaneous bacterial peritonitis (SBP) than non-PPI users. We aimed to identify whether PPI use is an independent risk factor for the development of SBP among cirrhotic patients in the United States (US).
UNASSIGNED: We enrolled a retrospective cohort using a validated multicenter database. Patients with a SNOMED-CT diagnosis of \"cirrhosis\" between 1999 and 2022 were identified. All patients below 18 years of age were excluded. We calculated the prevalence of individuals using PPIs in the total US population and in cirrhotic patients from 1999 to date, and the incidence of SBP in the past year. Finally, we constructed a multivariate regression model, controlling for multiple covariates.
UNASSIGNED: The final analysis included 377,420 patients. The 20-year-period prevalence of SBP in patients with cirrhosis was 3.54% and the prevalence of patients using PPIs in the US population was 12,000 per 100,000 people (12.00%). The 1-year incidence of SBP in cirrhotic patients using PPIs was 2500 per 100,000 people. After accounting for confounders, the risk of SBP was higher among males, patients with a diagnosis of gastrointestinal bleeding, and those using β-blockers and PPIs.
UNASSIGNED: To date, this is the largest cohort used to examine the prevalence of SBP among cirrhotic patients in the US. PPI use and hepatic encephalopathy offered the highest risk for the development of SBP, independently of gastrointestinal bleeding. Focusing on judicious PPI use should be encouraged among cirrhotic patients.
UNASSIGNED: We enrolled a retrospective cohort using a validated multicenter database. Patients with a SNOMED-CT diagnosis of \"cirrhosis\" between 1999 and 2022 were identified. All patients below 18 years of age were excluded. We calculated the prevalence of individuals using PPIs in the total US population and in cirrhotic patients from 1999 to date, and the incidence of SBP in the past year. Finally, we constructed a multivariate regression model, controlling for multiple covariates.
UNASSIGNED: The final analysis included 377,420 patients. The 20-year-period prevalence of SBP in patients with cirrhosis was 3.54% and the prevalence of patients using PPIs in the US population was 12,000 per 100,000 people (12.00%). The 1-year incidence of SBP in cirrhotic patients using PPIs was 2500 per 100,000 people. After accounting for confounders, the risk of SBP was higher among males, patients with a diagnosis of gastrointestinal bleeding, and those using β-blockers and PPIs.
UNASSIGNED: To date, this is the largest cohort used to examine the prevalence of SBP among cirrhotic patients in the US. PPI use and hepatic encephalopathy offered the highest risk for the development of SBP, independently of gastrointestinal bleeding. Focusing on judicious PPI use should be encouraged among cirrhotic patients.
摘要：
■最近的研究结果表明，使用质子泵抑制剂（PPI）的肝硬化患者发生自发性细菌性腹膜炎（SBP）的风险高于非PPI使用者。我们的目的是确定在美国（US）的肝硬化患者中使用PPI是否是SBP发展的独立危险因素。
■我们使用经过验证的多中心数据库注册了一个回顾性队列。确定了1999年至2022年之间SNOMED-CT诊断为“肝硬化”的患者。所有18岁以下的患者被排除在外。我们计算了1999年至今在美国总人口和肝硬化患者中使用PPI的个体的患病率，以及过去一年中SBP的发病率。最后,我们构建了一个多元回归模型，控制多个协变量。
■最终分析包括377,420名患者。肝硬化患者SBP的20年患病率为3.54％，美国人群中使用PPI的患者患病率为12,000/100,000（12.00％）。使用PPI的肝硬化患者中SBP的1年发病率为2500/100,000人。在考虑了混杂因素之后，男性SBP的风险较高，诊断为消化道出血的患者，以及使用β受体阻滞剂和PPI的患者。
■到目前为止，这是用于检查美国肝硬化患者中SBP患病率的最大队列.PPI使用和肝性脑病为SBP的发展提供了最高的风险，独立于消化道出血。应鼓励肝硬化患者明智地使用PPI。
■我们使用经过验证的多中心数据库注册了一个回顾性队列。确定了1999年至2022年之间SNOMED-CT诊断为“肝硬化”的患者。所有18岁以下的患者被排除在外。我们计算了1999年至今在美国总人口和肝硬化患者中使用PPI的个体的患病率，以及过去一年中SBP的发病率。最后,我们构建了一个多元回归模型，控制多个协变量。
■最终分析包括377,420名患者。肝硬化患者SBP的20年患病率为3.54％，美国人群中使用PPI的患者患病率为12,000/100,000（12.00％）。使用PPI的肝硬化患者中SBP的1年发病率为2500/100,000人。在考虑了混杂因素之后，男性SBP的风险较高，诊断为消化道出血的患者，以及使用β受体阻滞剂和PPI的患者。
■到目前为止，这是用于检查美国肝硬化患者中SBP患病率的最大队列.PPI使用和肝性脑病为SBP的发展提供了最高的风险，独立于消化道出血。应鼓励肝硬化患者明智地使用PPI。
