The Effect Of Albumin Therapy On The Prognosis Of Patients With Cirrhosis: A Systematic Review

Objective: To systematically evaluate effects of short-term and long-term albumin administration on the prognosis of patients with cirrhosis based on existing randomized controlled trials.Methods: Randomized controlled trials on short-term or long-term application of albumin for the treatment of patients with cirrhosis up to March 2022 were searched by searching the databases: pub Med,The cochrane library,Embase,China Knowledge Network(CNKI),Wanfang database,Wipu database,and China Biomedical Database(CBM),and the characteristics of the included studies were extracted information and related data results,and meta-analysis was performed using Revman 5.4 software.Results: A total of 11 relevant papers were included,of which the first part(metaanalysis of the prognostic impact of short-term application of albumin therapy on patients with cirrhosis)included 7 papers with 1442 patients,the number of albumin group was 702 and 740 in the control group,and the second part(meta-analysis of the prognostic impact of long-term application of albumin therapy on patients with cirrhosis)included 4 papers with 628 patients enrolled,the number of albumin The results of Meta-analysis showed that in the first part: there was no statistical difference in 90-day mortality,incidence of hepatic encephalopathy,incidence of ruptured bleeding from gastroesophageal varices,incidence of renal insufficiency,incidence of multi-organ failure and liver transplantation rate between the albumin combined with standard treatment regimen group and the standard treatment regimen group alone(P> 0.05),while the incidence of pulmonary edema was significantly higher in the albumin-combined standard treatment regimen group than in the standard treatment regimen alone(RR=4.28,P=0.0007);In the second part: there was no statistical difference between the albumin-combined standard treatment regimen group and the standard treatment regimen group alone in terms of mortality and liver transplantation rates(P>0.05),while there was no statistical difference between the two groups in terms of total complication The incidence of total complications,readmission rate,and ascites recurrence rate were significantly lower in the albumincombined standard treatment regimen group than in the standard treatment regimen alone group(RR=0.70,P=0.002;RR=0.75,P=0.04;RR=0.52,P<0.00001).Conclusion: Short-term administration of albumin to patients with cirrhosis during hospitalization did not improve 90-day mortality,liver transplantation rates,or reduce the risk of hepatic encephalopathy,ruptured bleeding from gastroesophageal varices,renal insufficiency,and multiorgan failure,but increased the probability of adverse pulmonary edema events.Long-term albumin treatment for cirrhotic patients did not significantly improve mortality or liver transplantation rates,but it reduced the overall complication rate,readmission rate,and ascites recurrence rate in cirrhotic patients.