Key result
Non-use of non-selective beta-blockers in cirrhosis is linked to ~67% higher risk of serious infection.
Why the study?
Therapeutic effects of non-selective beta-blockers on cirrhotic complications beyond portal hypertension, including infection, AKI, renal function decline, and sarcopenic changes, were scarcely studied.
Cohort (n=166)
No
Odds Ratio: 1.666 (95% CI 1.036–2.679)
p-value: p=0.035
Supports NSBBs for lower infection risk in cirrhosis; observational data leaves open need for RCTs before practice change.
BACKGROUND: Cirrhotic complications resulting from portal hypertension can be considerably reduced by non-selective beta-blockers (NSBBs); however, scarce studies have investigated therapeutic agents for other complications. We aimed to investigate the effects of NSBBs on common cirrhotic complications of infection, acute kidney injury (AKI), chronic renal function declination, and sarcopenic changes. METHODS: Medical records of hospitalization for cirrhosis with at least a 4-year follow-up were analyzed and selected using propensity-score matching (PSM). Generalized estimating equation (GEE) was applied to assess the association of NSBBs with infection requiring hospitalization and AKI. Chronic renal function declination was evaluated by slope of regression lines derived from reciprocal of the serum creatinine level. The covariates of CT-measured skeletal muscle index (SMI) alterations were analyzed by generalized linear mixed model. RESULTS: Among the 4946 reviewed individuals, 166 (83 NSBB group, 83 non-NSBB group) were eligible. Using GEE, Charlson comorbidity index, Child-Pugh score and non-NSBB were risk factors for infection; non-NSBB group revealed a robust trend toward AKI, showed no significant difference with chronic renal function declination of NSBB group, and was negatively associated with SMI alteration. CONCLUSION: Chronic NSBB use lowered the episodes of infection requiring hospitalization and AKIs, whereas non-NSBB was associated with sarcopenic changes.
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Li et al. (2021) conducted a cohort in Cirrhosis (n=166). Non-selective beta-blockers (NSBBs) vs. Non-NSBB use was evaluated on Infection episodes requiring hospitalization (OR 1.666 (for non-NSBB vs NSBB), 95% CI 1.036-2.679, p=0.035). Chronic use of non-selective beta-blockers in patients with cirrhosis was associated with a decreased risk of infection requiring hospitalization compared to non-users (non-NSBB OR 1.666).
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