Copyright ©The Author(s) 2019.
World J Gastroenterol. Jun 7, 2019; 25(21): 2683-2698
Published online Jun 7, 2019. doi: 10.3748/wjg.v25.i21.2683
Table 1 Characteristics of included studies
Author, YearLocationDesignNo. of cases/controlsAge of cases/controlsSex (% male) cases/controlsType of liver diseaseOutcomes analyzedDefinition of PPI useFollow-up timeAdjusted factorsQuality score
Lin et al[18], 2014ChinaCase-control55/11046 (37-55)/43 (36-48)83.6/75.5HBV-related ACLFGrades 2-4 HEPatients using any PPI intravenously for at least 6 d before the occurrence of HE at the admission timeNAAge, sex, MELD score, infection, hypokalemia, hyponatraemia, ascites, PTA, AFP, lactulose use, branched chain amino acids, and arginine hydrochloride8
Dam et al[17], 2016DenmarkCohort340/52558 (50-64)/57 (51-64)68/69Cirrhosis with ascitesGrades 1-4 HE; grades 2-4 HEA patient counted as a PPI user when he or she was using PPIs and as a nonuser when he or she was not148.2 person-years/186.1 person-yearsSex, age at inclusion, cirrhosis etiology, variceal bleeding, MELD score, serum sodium, albumin, and platelets; and lactulose use, spironolactone dose, furosemide dose, and potassiumsparing diuretic dose9
Tsai et al[16], 2016TaiwanCase-control1166/116653.09 ± 13.80/53.14 ± 13.7874.2/74.2CirrhosisGrades 1-4 HEPPI use was defined as > 30 cumulative defined daily doses (cDDDs); PPI non-use was defined as ≤ 30 cDDDs2.96 ± 3.40/2.87 ± 3.57 yrAge, sex, income, level of urbanization, the use of PPIs in the past 6 mo before enrollment, Charlson Comobidity Index score, medical comorbidities, use of medication9
Zhu et al[15], 2018ChinaCase-control128/12858.34 ± 11.15/58.28 ± 10.9763.3/63.3CirrhosisGrades 1-4 HEPPI userswere defined as the patients who used PPIs during hospitalizationNAAge, gender, Child-Pugh score, hemoglobin, gammaglutamyl transpeptidase, blood urea nitrogen, ammonia, international normalized ratio, and acute upper gastrointestinal bleeding8
Nardelli et al[14], 2018ItalyCohort125/18561.5 ± 11.9/63.3 ± 11.674.1/67.2CirrhosisMinimal HE; grades 2-4 HEPatients were considered PPIs users when the treatment started at least 4 wk prior to the admission14.1 ± 12.3 moMELD scores, MHE, previous overt HE, PPIs, age, albumin and sodium levels9
Sturm et al[13], 2018GermanyCohort303/9459.2 ± 11.7/59.7 ± 10.267.7/69.1Cirrhosis with TIPS implantationGrades 1-4 HEPPI userswere defined as the patients who used PPIs during hospitalization116 ± 74 /135 ± 65 dAge, etiology of liver disease, TIPS indication, acute variceal bleeding with early TIPS implantation, covering of the stent graft, portosystemic gradient before and after TIPS, HE before TIPS, MELD score, HE medication, and peri-interventional antibiotic treatment9
Tapper et al[24], 2018 (abstract)USACohort18648165 (57–73)55CirrhosisGrades 1-4 HEChronic use (> 90 d)542739 patient-yearsAge, sex, race, etiology of cirrhosis, Medicaid coenrollment, hemodialysis, portal hyperten-sion (varices, ascites, TIPS placement), and management by a gastroenterologistNA
Matei et al[25], 2017 (abstract)RomaniaCase-control436/32760.41 (17–91)63.3Cirrhosis and ascitesGrades 1-4 HEPPIs use was defined as the administration of at least 40 mg/day, for minimum 2 wk during the last 3 moNANANA
Shanab et al[23], 2018 (abstract)UKCase-control506/32053.4 ± 12.066CirrhosisGrades 1-4 HECurrent PPI useNANANA