Prognosis of patients with ascites after PleurX insertion: an observational study

TY - JOUR

T1 - Prognosis of patients with ascites after PleurX insertion

T2 - an observational study

AU - Riedel, Agnete Nordheim

AU - Kimer, Nina

AU - Hobolth, Lise

AU - Gluud, Lise Lotte

PY - 2018/3/4

Y1 - 2018/3/4

N2 - OBJECTIVE: To evaluate the safety of PleurX in cirrhotic patients with refractory ascites.METHODS: We prospectively registered patients who received a PleurX catheter cirrhosis-associated refractory ascites at our department from July 2015 to November 2016. Our control group consisted of matched cirrhotic patients with refractory ascites treated with large volume paracentesis (LVP) and patients with malignant ascites treated with PleurX during the same period.RESULTS: We included 25 patients with cirrhosis-related ascites (7 in PleurX group) and 17 with malignant ascites (14 in PleurX group). Of these, six patients had hepatocellular carcinoma and cirrhosis (5 in PleurX group). None were eligible for insertion of a TIPS or liver transplantation. The maximum duration of follow-up was (480 days) in the PleurX group and 366 days in the LVP group (median 84 and 173 days, respectively). There was no difference in mortality when comparing PleurX with LVP treatment (hazard ratios: 3.0 and 1.0, p = .23 and .96, respectively). Mortality was higher in patients with malignant ascites (p= .01). We found no significant differences in adverse events (incl. spontaneous bacterial peritonitis) or in P-albumin, P-creatinine and P-sodium between the groups.CONCLUSION: PleurX insertion for the treatment of refractory ascites in cirrhotic patients appears to be safe. Prospective randomized trials are necessary in order to confirm these findings.

AB - OBJECTIVE: To evaluate the safety of PleurX in cirrhotic patients with refractory ascites.METHODS: We prospectively registered patients who received a PleurX catheter cirrhosis-associated refractory ascites at our department from July 2015 to November 2016. Our control group consisted of matched cirrhotic patients with refractory ascites treated with large volume paracentesis (LVP) and patients with malignant ascites treated with PleurX during the same period.RESULTS: We included 25 patients with cirrhosis-related ascites (7 in PleurX group) and 17 with malignant ascites (14 in PleurX group). Of these, six patients had hepatocellular carcinoma and cirrhosis (5 in PleurX group). None were eligible for insertion of a TIPS or liver transplantation. The maximum duration of follow-up was (480 days) in the PleurX group and 366 days in the LVP group (median 84 and 173 days, respectively). There was no difference in mortality when comparing PleurX with LVP treatment (hazard ratios: 3.0 and 1.0, p = .23 and .96, respectively). Mortality was higher in patients with malignant ascites (p= .01). We found no significant differences in adverse events (incl. spontaneous bacterial peritonitis) or in P-albumin, P-creatinine and P-sodium between the groups.CONCLUSION: PleurX insertion for the treatment of refractory ascites in cirrhotic patients appears to be safe. Prospective randomized trials are necessary in order to confirm these findings.

KW - Aged

KW - Ascites/etiology

KW - Bacterial Infections/etiology

KW - Carcinoma, Hepatocellular/complications

KW - Catheters, Indwelling/adverse effects

KW - Denmark

KW - Female

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Liver Cirrhosis/complications

KW - Male

KW - Middle Aged

KW - Paracentesis/adverse effects

KW - Peritonitis/etiology

KW - Prognosis

KW - Prospective Studies

KW - Survival Analysis

KW - Treatment Outcome

U2 - 10.1080/00365521.2018.1436190

DO - 10.1080/00365521.2018.1436190

M3 - Journal article

C2 - 29411667

SN - 0036-5521

VL - 53

SP - 340

EP - 344

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

IS - 3

ER -