| アブストラクト | BACKGROUND: Hepatorenal syndrome (HRS) is a life-threatening complication of end-stage liver disease. This study aimed to clarify the status of HRS in Japan by analyzing the Japanese Diagnosis Procedure Combination database. METHODS: Patients hospitalized for cirrhosis and HRS from July 2010 to March 2019 were sampled. They were divided into two groups according to their prognosis upon discharge: the transplant-free survival group and the death or liver transplantation group. The two groups' baseline patient characteristics and treatments were compared. RESULTS: The mean age of the 1,412 participants was 67.3 years (standard deviation: 12.3 years), and 65.4% were male. The Child-Pugh grades was B and C in 18.8% and 81.2%, respectively. Hepatocellular carcinoma was present in 27.1% of the patients, and the proportion of spontaneous bacterial peritonitis was 2.3%. Albumin, noradrenaline, and dopamine were administered to 57.9%, 8.0%, and 14.9% of the patients, respectively; 7.0% of the patients underwent renal replacement therapy; and 5.0% were admitted to the intensive care unit. Intravenous antibiotics were administered to 30.8% of the patients. A total of 925 patients (65.5%) died or underwent liver transplantation. In addition to a higher proportion of patients with poor baseline liver function, the death or liver transplantation group included more males, patients with hepatocellular carcinoma, and those with spontaneous bacterial peritonitis. CONCLUSIONS: HRS in Japan has a high mortality rate. Albumin was administered to over 50% of participants. Although noradrenaline is recommended in Japanese clinical guidelines, dopamine was more frequently used as a vasoconstrictor in clinical practice. |
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| ジャーナル名 | BMC gastroenterology |
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| Pubmed追加日 | 2023/6/24 |
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| 投稿者 | Okushin, Kazuya; Yamana, Hayato; Tateishi, Ryosuke; Sato, Masaya; Tsutsumi, Takeya; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Koike, Kazuhiko; Fujishiro, Mitsuhiro |
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| 組織名 | Department of Gastroenterology, Graduate School of Medicine, The University of;Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.;Department of Infection Control and Prevention, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Data Science Center, Jichi Medical University, Shimotsuke, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. tateishi-tky@umin.ac.jp.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School, Tokyo, Japan.;Kanto Central Hospital, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37353737/ |
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