Abstract
Background and Aims
The efficacy and safety of albumin infusion for treatment and prevention of overt
hepatic encephalopathy (OHE) among cirrhosis patients remained controversial. We performed
a systematic review and meta-analysis to evaluate the benefit of albumin infusion
for the treatment and prevention of OHE.
Methods
We performed a systematic search of 4 electronic databases up to 31st January 2021.
The primary outcome was the resolution of OHE. Secondary outcomes were inpatient mortality
and albumin-associated adverse events. We assessed the pooled odds’ risk, pooled mean
differences, 95% confidence interval and heterogeneity using Review Manager Version
5.3.
Results
A total of 12 studies (2,087 subjects) were identified. Among cirrhosis patients with
OHE, albumin infusion was associated with a lower pooled risk of OHE (OR=0.43, 95%CI:
0.27, 0.68; I2=0%). Among patients without baseline OHE, albumin infusion was associated with a
lower pooled risk of developing OHE (OR=0.53, 95%CI: 0.32, 0.86; I2=62%). Albumin infusion was associated with a lower pooled risk of inpatient mortality
(OR=0.36, 95%CI: 0.21, 0.60; I2=0%).
Conclusion
Well-powered randomized trials are required to confirm the benefits of albumin infusion
for the prevention and treatment of overt hepatic encephalopathy among decompensated
cirrhosis patients.
Keywords
Abbreviations:
HE (hepatic encephalopathy), HBV (hepatitis B virus), HCV (hepatitis C virus), RCT (randomized controlled trial), OR (odd's ratio), CI (confidence interval), MELD (model of end-stage liver disease), SD (standard deviation), CVP (central venous pressure)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 16, 2021
Accepted:
April 22,
2021
Received:
March 31,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
