SHM Converge Scientific Abstract ePoster Gallery-Inappropriate Proton Pump Inhibitors Use in Cirrhosis May Worsen Outcomes

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This poster examined whether proton pump inhibitor (PPI) use is associated with worse outcomes in patients with cirrhosis being evaluated for liver transplantation. The study was motivated by evidence that PPIs have been linked to adverse events and higher mortality in cirrhosis, despite not being routinely recommended unless clearly indicated.<br /><br />Researchers performed a retrospective review of 458 cirrhosis patients undergoing outpatient liver transplant evaluation. Patients were grouped by gastroesophageal reflux disease (GERD) diagnosis and PPI use: GERD with PPI, GERD without PPI, no GERD with PPI, and no GERD without PPI. They compared variceal bleed history and other complications, including hepatic encephalopathy, jaundice, TIPS placement, malnourishment, and transplantation. Statistical analyses included chi-square tests and logistic regression.<br /><br />Key findings:<br />- 33.6% of patients had GERD, but 57.6% were taking a PPI.<br />- Among patients with GERD, 75% were appropriately prescribed a PPI.<br />- Half of the patients without GERD were inappropriately taking a PPI.<br />- Variceal bleeding was more common in patients on PPIs than in those not on PPIs (40.2% vs. 15.9%, p=0.01).<br />- After adjusting for age and ethnicity, patients without GERD who were on a PPI were 3.5 times more likely to have had a variceal bleed.<br /><br />The authors conclude that inappropriate PPI use in cirrhosis may worsen outcomes, especially when PPIs are continued without a valid indication. They recommend careful reassessment of PPI therapy in patients with advanced liver disease, particularly those awaiting transplant evaluation.

Asset Subtitle

Katherine M. Cooper

Meta Tag

Author List Alessandro Colletta, Deepika Devuni, Katherine M. Cooper, Mason Winkie, Sierra Anderson

Category Research

Concept Proton Pump Inhibitor

Concept Esophageal Varices

Concept Cirrhosis

Concept Liver Transplant Evaluation

Distinguished Non-Finalist

Presenter Organization University of Massachusetts Medical School

Presenting Author Katherine M. Cooper

Track Outcomes Research

Keywords

proton pump inhibitor

PPI use

cirrhosis

liver transplantation

GERD

variceal bleeding

hepatic encephalopathy

retrospective study

transplant evaluation

adverse outcomes

Proton Pump Inhibitor

Esophageal Varices

Cirrhosis

Liver Transplant Evaluation