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    題名: Mortality Following Catheter Drainage Versus Thoracentesis in Cirrhotic Patients with Pleural Effusion
    作者: Hung, T. H.;Tseng, C. W.*;Tsai, C. C.;Hsieh, Y. H.;Tseng, K. C.;Tsai, C. C.
    關鍵詞: Liver cirrhosis;Pleural effusion;Catheter drainage;Thoracentesis
    日期: 2017-04
    上傳時間: 2017-10-27 02:10:26 (UTC+8)
    摘要: Pleural effusion is an abnormal collection of body fluids that may cause related morbidity or mortality in cirrhotic patients. There are insufficient data to determine the optimal method of drainage, for symptomatic relief in cirrhotic patients with pleural effusion.

    Aims

    In this study, we compare the mortality outcomes of catheter drainage versus thoracentesis in cirrhotic patients.

    Methods

    The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify cirrhotic patients with pleural effusion requiring drainage between January 1, 2007, and December 31, 2010. In all, 2556 cirrhotic patients with pleural effusion were selected for the study and divided into the two groups (n = 1278/group) after propensity score matching.

    Results

    The mean age was 61.0 ± 14.3 years, and 68.9% (1761/2556) were men. The overall 30-day mortality was 21.0% (538/2556) and was higher in patients treated with catheter drainage than those treated with thoracentesis (23.5 vs. 18.6%, respectively, P < 0.001 by log-rank test). After Cox proportional hazard regression analysis adjusted by patient sex, age, and comorbid disorders, the risk of 30-day mortality was significantly higher in cirrhotic patients who accepted catheter drainage compared to thoracentesis (hazard ratio 1.30, 95% confidence interval 1.10–1.54, P = 0.003). Old age, hepatic encephalopathy, bleeding esophageal varices, hepatocellular carcinoma, ascites, and pneumonia were associated with higher risks for 30-day mortality.

    Conclusion

    In cirrhotic patients with pleural effusion requiring drainage, catheter drainage is associated with higher mortality compared to thoracentesis.
    關聯: Digestive Diseases and Sciences 62(4), p. 1080–1085
    DOI: 10.1007/s10620-017-4463-8
    顯示於類別:[應用數學與數據科學學系] 期刊論文

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