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  • Wiley  (5)
  • 2015-2019  (5)
  • 2018  (5)
  • 1
    Online Resource
    Online Resource
    How can we improve the performance of Model for End‐Stage Liver Disease sodium score in patients with hepatitis B virus‐related decompensated liver cirrhosis commencing antiviral treatment?
    Wiley ; 2018
    In:  Journal of Gastroenterology and Hepatology Vol. 33, No. 9 ( 2018-09), p. 1641-1648
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 33, No. 9 ( 2018-09), p. 1641-1648
    Abstract: We aimed to develop a more efficient prognostic model to predict 1‐year mortality in patients with hepatitis B virus‐related decompensated cirrhosis beginning antiviral treatment. Methods Using Cox regression analysis, survival analyses were performed on 554 patients with decompensated cirrhosis who were followed up from the start of nucleos(t)ide analogue antiviral treatment. Results At baseline, ascites and hepatic encephalopathy were found in 78.0% and 18.1% of patients, respectively. Eighty‐six events (77 deaths and 9 emergency liver transplants) occurred within the first year of treatment. Severity of ascites, presence of hepatic encephalopathy, and the Model for End‐Stage Liver Disease (MELD)–sodium (MELDNa) score were independent risk factors for 1‐year mortality. The new prognostic model (the revised MELDNa) constructed by adding ascites and encephalopathy to the MELDNa score significantly improved the area under the receiver operating characteristics curve for predicting 1‐year events at baseline compared with the Child‐Turcotte‐Pugh system, MELD and MELDNa models, and Fontana index (0.905 vs 0.867, 0.843, 0.871, and 0.815, respectively; P   〈  0.05). Furthermore, repetitive application of revised MELDNa at 0, 1, 2, 3, and 6 months of treatment could predict 81.4% (70/86) of 1‐year events, which was significantly ( P   〈  0.05) higher than the sensitivity of the Child‐Turcotte‐Pugh system (68.6%), MELD (70.9%) and MELDNa (68.6%) scores, and Fontana index (64.0%), achieving similar specificities of ~96%. Conclusions Ascites and encephalopathy should be considered together with the MELDNa score when predicting short‐term mortality and planning liver transplant in patients with decompensated hepatitis B virus‐related cirrhosis starting antiviral treatment.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.2018.33.issue-9
    DOI: 10.1111/jgh.14128
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2006782-3
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  • 2
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    Validation of prognostic scores to predict short‐term mortality in patients with acute‐on‐chronic liver failure
    Wiley ; 2018
    In:  Journal of Gastroenterology and Hepatology Vol. 33, No. 4 ( 2018-04), p. 900-909
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 33, No. 4 ( 2018-04), p. 900-909
    Abstract: The aim of this study was to validate the chronic liver failure‐sequential organ failure assessment score (CLIF‐SOFAs), CLIF consortium organ failure score (CLIF‐C OFs), CLIF‐C acute‐on‐chronic liver failure score (CLIF‐C ACLFs), and CLIF‐C acute decompensation score in Korean chronic liver disease patients with acute deterioration. Methods Acute‐on‐chronic liver failure was defined by either the Asian Pacific Association for the study of the Liver ACLF Research Consortium (AARC) or CLIF‐C criteria. The diagnostic performances for short‐term mortality were compared by the area under the receiver operating characteristic curve. Results Among a total of 1470 patients, 252 patients were diagnosed with ACLF according to the CLIF‐C (197 patients) or AARC definition (95 patients). As the ACLF grades increased, the survival rates became significantly lower. The areas under the receiver operating characteristic of the CLIF‐SOFAs, CLIF‐C OFs, and CLIF‐C ACLFs were significantly higher than those of the Child–Pugh, model for end‐stage liver disease, and model for end‐stage liver disease‐Na scores in ACLF patients according to the CLIF‐C definition (all P   〈  0.05), but there were no significant differences in patients without ACLF or in patients with ACLF according to the AARC definition. The CLIF‐SOFAs, CLIF‐C OFs, and CLIF‐C ACLFs had higher specificities with a fixed sensitivity than liver specific scores in ACLF patients according to the CLIF‐C definition, but not in ACLF patients according to the AARC definition. Conclusions The CLIF‐SOFAs, CLIF‐C OFs, and CLIF‐C ACLFs are useful scoring systems that provide accurate information on prognosis in patients with ACLF according to the CLIF‐C definition, but not the AARC definition.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.2018.33.issue-4
    DOI: 10.1111/jgh.13991
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2006782-3
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  • 3
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    Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites
    Wiley ; 2018
    In:  Journal of Gastroenterology and Hepatology Vol. 33, No. 4 ( 2018-04), p. 910-917
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 33, No. 4 ( 2018-04), p. 910-917
    Abstract: Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. Methods Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS‐1). Results In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, and 267 patients (76.3%) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3%), followed by chronic viral hepatitis (29.7%). Serum creatinine and cystatin C levels were 0.9 ± 0.4 mg/dL and 1.1 ± 0.5 mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS‐1. Serum creatinine level was not significantly associated with mortality and development of HRS‐1 on multivariate analysis. Conclusion Serum cystatin C level was an independent predictor of mortality and development of HRS‐1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.2018.33.issue-4
    DOI: 10.1111/jgh.13983
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2006782-3
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  • 4
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    Reduced risk of hepatocellular carcinoma by achieving a subcirrhotic liver stiffness through antiviral agents in hepatitis B virus‐related advanced fibrosis or cirrhosis
    Wiley ; 2018
    In:  Journal of Gastroenterology and Hepatology Vol. 33, No. 2 ( 2018-02), p. 503-510
    Details
    In: Journal of Gastroenterology and Hepatology, Wiley, Vol. 33, No. 2 ( 2018-02), p. 503-510
    Abstract: A subcirrhotic range of liver stiffness (sc‐LS), assessed by transient elastography, is associated with better outcomes in patients with chronic hepatitis B (CHB). We investigated whether the achievement of sc‐LS by antiviral therapy (AVT) reduced the risk of developing hepatocellular carcinoma (HCC) in patients with CHB‐related advanced fibrosis or cirrhosis. Methods In total, 209 patients with CHB‐related advanced fibrosis or cirrhosis, who received paired transient elastography examinations during AVT between 2007 and 2012, were enrolled. The cut‐off LS value for ultrasonographic cirrhosis was defined as 11.6 kPa. Results The median age of the study population was 51 years, with males predominating ( n  = 138, 66.0%). The median LS value at enrollment was 14.1 kPa (interquartile range: 9.5–24.1 kPa). After 2 years of AVT, 140 (67.0%) patients achieved sc‐LS. During the study period, 28 (13.4%) patients developed HCC after 2 years of AVT. On multivariate analysis, the achievement of sc‐LS after AVT was independently associated with a decreased risk of HCC development (hazard ratio [HR] = 0.485, P  = 0.047), whereas older age (HR = 1.071) and male gender (HR = 3.704) were independently associated with an increased HCC risk (both P   〈  0.05). Patients with a cirrhotic range of LS value after 2 years of AVT were at a higher risk of HCC development than those with sc‐LS (log‐rank test, P  = 0.020). Conclusions The achievement of sc‐LS after AVT can reduce the risk of HCC development in patients with CHB, even when advanced fibrosis or cirrhosis is apparent on starting AVT.
    Type of Medium: Online Resource
    ISSN: 0815-9319 , 1440-1746
    URL: Issue
    URL: Article
    DOI: 10.1111/jgh.2018.33.issue-2
    DOI: 10.1111/jgh.13854
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2006782-3
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  • 5
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    Comparative study of Helicobacter pylori eradication rates of concomitant therapy vs modified quadruple therapy comprising proton‐pump inhibitor, bismuth, amoxicillin, and metronidazole in Korea
    Wiley ; 2018
    In:  Helicobacter Vol. 23, No. 2 ( 2018-04)
    Details
    In: Helicobacter, Wiley, Vol. 23, No. 2 ( 2018-04)
    Abstract: The standard triple Helicobacter pylori regimen now shows unacceptably low treatment success in Korea. Administration of the concomitant therapy for 10 days, which has a high cure rate, is recommended as an alternative first‐line treatment in areas of high clarithromycin resistance including Korea. Recently, modified bismuth‐containing quadruple therapy with amoxicillin ( PAM ‐B therapy) showed excellent results, regardless of dual clarithromycin and metronidazole resistance. This study compared the concomitant therapy with PAM ‐B therapy as a first‐line treatment for H. pylori infection. Method Subjects infected with H. pylori and naïve to treatment were performed a head‐to‐head comparison between 10‐day concomitant therapy [rabeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily] and 14‐day PAM ‐B therapy [rabeprazole 20 mg, amoxicillin 1 g, metronidazole 750 mg, and tripotassium dicitrato bismuthate 600 mg (elemental bismuth 240 mg) twice daily]. Six weeks after treatment, H. pylori eradication was assessed. Results Two hundred and seventy subjects were randomized. Both regimens achieved high cure rates: 83.0% (112/135) and 88.1% (119/135) by the intention‐to‐treat analysis and 95.5% (106/111) and 96.6% (114/118) by the per‐protocol analysis, respectively. The intention‐to‐treat and per‐protocol analyses revealed no statistically significant difference in the eradication rate ( P  = .299 and P  = .743, respectively). Rates of adverse events were similar between groups (25.2% vs 23.0%, P ‐value: .776) Adverse events, which resulted in poor compliance, occurred in six patients of each group, but there were no serious complications. Conclusions PAM ‐B therapy is as effective as concomitant therapy for eradicating H. pylori with comparative safety. PAM ‐B therapy is regarded as a promising alternative to standard triple therapy for a first‐line eradication in Korea.
    Type of Medium: Online Resource
    ISSN: 1083-4389 , 1523-5378
    URL: Issue
    URL: Article
    DOI: 10.1111/hel.2018.23.issue-2
    DOI: 10.1111/hel.12466
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2020336-6
    SSG: 12
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