{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:38:14Z","timestamp":1776893894489,"version":"3.51.2"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Proton pump inhibitors (PPI) are frequently used in patients with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to determine whether PPI use is associated with the prognosis of cirrhotic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicentre retrospective cohort study involving 1485 patients who had experienced hepatic encephalopathy (HE) from 7 referral centres in Korea. The primary outcome was overall survival and secondary outcomes included the development of cirrhotic complications, including recurrent HE, spontaneous bacterial peritonitis (SBP), hepatorenal syndrome (HRS), and gastrointestinal bleeding. Patients treated with PPI with a mean defined daily dose (mDDD) \u22650.5 (high\u2010dose PPI group) were compared to those treated with PPI of an mDDD\u2009&lt;\u20090.5 (No or low\u2010dose PPI group) for each outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1485 patients (median age, 61\u2009years; male, 61%), 232 were assigned to the high\u2010dose PPI group. High\u2010dose PPI use was independently associated with a higher risk of death (adjusted HR [aHR]\u2009=\u20091.71, 95% confidence interval [CI]\u2009=\u20091.38\u20132.11, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). This result was reproducible after propensity score\u2010matching (PSM) (aHR\u2009=\u20091.90, 95% CI\u2009=\u20091.49\u20132.44, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). High\u2010dose PPI use was an independent risk factor of recurrent HE (before PSM: aHR\u2009=\u20092.04, 95% CI\u2009=\u20091.66\u20132.51, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; after PSM: aHR\u2009=\u20092.16, 95% CI\u2009=\u20091.70\u20132.74, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), SBP (before PSM: aHR\u2009=\u20091.87, 95% CI\u2009=\u20091.43\u20132.43, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; after PSM: aHR\u2009=\u20091.76, 95% CI\u2009=\u20091.31\u20132.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), HRS (before PSM: aHR\u2009=\u20091.48, 95% CI\u2009=\u20091.02\u20132.15, <jats:italic>p<\/jats:italic>\u2009=\u20090.04; after PSM: aHR\u2009=\u20091.47, 95% CI\u2009=\u20090.95\u20132.28, <jats:italic>p<\/jats:italic>\u2009=\u20090.09), and gastrointestinal bleeding (before PSM: aHR\u2009=\u20091.46, 95% CI\u2009=\u20091.12\u20131.90, <jats:italic>p<\/jats:italic>\u2009=\u20090.006; after PSM: aHR\u2009=\u20091.74, 95% CI\u2009=\u20091.28\u20132.37, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of high\u2010dose PPI was independently associated with increased risks of mortality and cirrhotic complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17909","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T06:34:42Z","timestamp":1708670082000},"page":"973-983","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["High\u2010dose proton pump inhibitor treatment is associated with a higher mortality in cirrhotic patients: A multicentre study"],"prefix":"10.1111","volume":"59","author":[{"given":"Jun Sik","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Busan Paik Hospital, Inje University College of Medicine  Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Hoon","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4944-4396","authenticated-orcid":false,"given":"Soo Young","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine School of Medicine, Kyungpook National University, Kyungpook National University Hospital  Daegu Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9658-8050","authenticated-orcid":false,"given":"Seung Up","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Yonsei Liver Center Severance Hospital, Yonsei University College of Medicine  Seoul Republic of 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National University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun Bin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0430-1607","authenticated-orcid":false,"given":"Han Ah","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine College of Medicine, Ewha Womans University  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5002-0822","authenticated-orcid":false,"given":"Gi\u2010Ae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyung Hee University School of Medicine  Seoul Republic of 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