Efficacy and safety of albumin infusion for overt hepatic encephalopathy: A systematic review and meta-analysis

• Published in: Digestive and liver disease Vol. 53; no. 7; pp. 817 - 823
• Main Authors: Teh, Kok Ban, Loo, Jing Hong, Tam, Yew Chong, Wong, Yu Jun
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.07.2021
• Subjects: Adult; Aged; Albumins; Albumins - administration & dosage; Female; Hepatic encephalopathy; Hepatic Encephalopathy - drug therapy; Hepatic Encephalopathy - etiology; Hepatic Encephalopathy - prevention & control; Humans; Infusions, Intravenous; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - drug therapy; Male; Middle Aged; Mortality; Risk Assessment; Treatment Outcome; RCT; OR; Mortality; CI; SD; Albumins; MELD; HCV; CVP; Liver cirrhosis; HE; HBV; Hepatic encephalopathy
• ISSN: 1590-8658; 1878-3562; 1878-3562
• DOI: 10.1016/j.dld.2021.04.030

The efficacy and safety of albumin infusion for treatment and prevention of overt hepatic encephalopathy (OHE) among cirrhosis patients remained controversial. We performed a systematic review and meta-analysis to evaluate the benefit of albumin infusion for the treatment and prevention of OHE. We performed a systematic search of 4 electronic databases up to 31st January 2021. The primary outcome was the resolution of OHE. Secondary outcomes were inpatient mortality and albumin-associated adverse events. We assessed the pooled odds’ risk, pooled mean differences, 95% confidence interval and heterogeneity using Review Manager Version 5.3. A total of 12 studies (2,087 subjects) were identified. Among cirrhosis patients with OHE, albumin infusion was associated with a lower pooled risk of OHE (OR=0.43, 95%CI: 0.27, 0.68; I2=0%). Among patients without baseline OHE, albumin infusion was associated with a lower pooled risk of developing OHE (OR=0.53, 95%CI: 0.32, 0.86; I2=62%). Albumin infusion was associated with a lower pooled risk of inpatient mortality (OR=0.36, 95%CI: 0.21, 0.60; I2=0%). Well-powered randomized trials are required to confirm the benefits of albumin infusion for the prevention and treatment of overt hepatic encephalopathy among decompensated cirrhosis patients.