| アブストラクト | AIM: Previous randomized controlled trials of branched-chain amino acid infusion for hepatic encephalopathy involved a small number of patients, and the effectiveness of branched-chain amino acid infusion has not been clarified. We evaluated whether branched-chain amino acid infusion in addition to lactulose treatment was associated with short-term outcomes in a large population of patients. METHODS: Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified inpatients with hepatic encephalopathy who received lactulose within 2 days of admission from July 2011 to March 2017. We divided the patients into those who received branched-chain amino acid infusion within 2 days of admission in addition to lactulose treatment and those who did not. We conducted propensity-score inverse probability of treatment weighting analyses to compare in-hospital mortality, consciousness at discharge, in-hospital complications, length of stay, and total hospitalization costs between the groups. RESULTS: We identified 8051 patients with hepatic encephalopathy treated with lactulose, including 7560 patients who received lactulose plus branched-chain amino acid infusion and 491 who received lactulose alone. The lactulose plus branched-chain amino acid infusion group had a significantly lower mortality than the lactulose alone group (9.6% vs. 15.0%, odds ratio 0.60, 95% confidence interval 0.44-0.82). The lactulose plus branched-chain amino acid infusion group also had a lower proportion of patients with impaired mental status at discharge, and lower total hospitalization costs than the lactulose alone group. CONCLUSIONS: Branched-chain amino acid infusion together with lactulose may improve the prognosis of hepatic encephalopathy. |
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| ジャーナル名 | Hepatology research : the official journal of the Japan Society of Hepatology |
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| 投稿日 | 2020/1/17 |
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| 投稿者 | Okada, Akira; Yamana, Hayato; Yamaguchi, Satoko; Ikeda Kurakawa, Kayo; Matsui, Hiroki; Fushimi, Kiyohide; Nangaku, Masaomi; Kadowaki, Takashi; Yasunaga, Hideo |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, The University of;Tokyo, Tokyo, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University,;Tokyo, Japan.;Division of Nephrology and Endocrinology, Graduate School of Medicine, The;Department of Metabolism and Nutrition, Teikyo University Mizonokuchi Hospital,;Kanagawa, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31943593/ |
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