2024
Severe Acute Liver Injury After Hepatotoxic Medication Initiation in Real-World Data
Torgersen J, Mezochow A, Newcomb C, Carbonari D, Hennessy S, Rentsch C, Park L, Tate J, Bräu N, Bhattacharya D, Lim J, Mezzacappa C, Njei B, Roy J, Taddei T, Justice A, Re V. Severe Acute Liver Injury After Hepatotoxic Medication Initiation in Real-World Data. JAMA Internal Medicine 2024, 184: 943-952. PMID: 38913369, PMCID: PMC11197444, DOI: 10.1001/jamainternmed.2024.1836.Peer-Reviewed Original ResearchIncidence rateUS Department of Veterans AffairsMedication initiationDepartment of Veterans AffairsInitiation of medicationVeterans AffairsMain OutcomesPotential of medicationsOutpatient settingDischarge diagnosisCohort studyDay of admissionCase reportReal World DataReport countsMedicationMedical cohortSevere acute liver injuryUS DepartmentFollow-upAcute liver injuryHospitalCohortHepatotoxic medicationsIncidenceScreening for Hepatocellular Carcinoma and Survival in Patients With Cirrhosis After Hepatitis C Virus Cure
Mezzacappa C, Kim N, Vutien P, Kaplan D, Ioannou G, Taddei T. Screening for Hepatocellular Carcinoma and Survival in Patients With Cirrhosis After Hepatitis C Virus Cure. JAMA Network Open 2024, 7: e2420963. PMID: 38985470, PMCID: PMC11238019, DOI: 10.1001/jamanetworkopen.2024.20963.Peer-Reviewed Original ResearchConceptsHepatitis C virus cureHepatitis C virusAssociated with improved overall survivalHepatocellular carcinoma diagnosisEarly-stage hepatocellular carcinomaImproved overall survivalOverall survivalHepatocellular carcinomaFollow-upHCC screeningCurative treatmentCumulative incidence of hepatocellular carcinomaDirect-acting antiviral (DAA) therapyCohort studyVeterans Affairs health care systemIncidence of hepatocellular carcinomaRisk of hepatocellular carcinomaCohort study of personsHepatitis C virus cirrhosisDiagnosis of hepatocellular carcinomaLikelihood of curative treatmentYears of follow-upHealth care systemHepatocellular carcinoma screeningHCV-related cirrhosisIdentification of hepatic steatosis among persons with and without HIV using natural language processing
Torgersen J, Skanderson M, Kidwai-Khan F, Carbonari D, Tate J, Park L, Bhattacharya D, Lim J, Taddei T, Justice A, Re V. Identification of hepatic steatosis among persons with and without HIV using natural language processing. Hepatology Communications 2024, 8: e0468. PMID: 38896066, PMCID: PMC11186806, DOI: 10.1097/hc9.0000000000000468.Peer-Reviewed Original ResearchConceptsImaging ReportingSteatotic liver diseaseHIV statusHepatic steatosisPrevalence of metabolic comorbiditiesImaging studiesVeterans Aging Cohort StudyCompare patient characteristicsPositive predictive valueAlcohol use disorderAging Cohort StudyIdentification of hepatic steatosisHIV infectionHepatitis BMetabolic comorbiditiesNatural language processing algorithmsRadiological studiesCohort studyPatient characteristicsClinical reviewLiver diseaseHIVPredictive valueUse disorderClinical image reportsTransjugular Intrahepatic Portosystemic Shunt Linked to Increased Risk of Hepatocellular Carcinoma: A VA Matched Cohort Study
Bansal S, Taddei T, Wells R, Serper M, Bittermann T, Mahmud N, Kaplan D. Transjugular Intrahepatic Portosystemic Shunt Linked to Increased Risk of Hepatocellular Carcinoma: A VA Matched Cohort Study. Journal Of Clinical And Translational Hepatology 2024, 12: 534-538. PMID: 38779520, PMCID: PMC11106346, DOI: 10.14218/jcth.2023.00554.Peer-Reviewed Original Research
2023
Liver Stiffness Measurement and Risk Prediction of Hepatocellular Carcinoma After HCV Eradication in Veterans With Cirrhosis
John B, Dang Y, Kaplan D, Jou J, Taddei T, Spector S, Martin P, Bastaich D, Chao H, Dahman B. Liver Stiffness Measurement and Risk Prediction of Hepatocellular Carcinoma After HCV Eradication in Veterans With Cirrhosis. Clinical Gastroenterology And Hepatology 2023, 22: 778-788.e7. PMID: 38061410, PMCID: PMC10960676, DOI: 10.1016/j.cgh.2023.11.020.Peer-Reviewed Original ResearchSustained virological responseLiver stiffness measurementHepatitis C virusHepatocellular carcinomaHCV cirrhosisDiabetes mellitusAnnual riskChronic hepatitis C virusPortal hypertension-related complicationsRate of HCCRisk of HCCHypertension-related complicationsRetrospective cohort studyVeterans Health AdministrationStiffness measurementHCV eradicationVirological responseCohort studyC virusHCC riskLower riskCirrhosisCutoff levelHealth AdministrationAbstractTextRates, patterns, and predictors of specialty palliative care consultation among patients with acute-on-chronic liver failure
Patel A, Walling A, Kanwal F, Serper M, Hernaez R, Sundaram V, Kaplan D, Taddei T, Mahmud N. Rates, patterns, and predictors of specialty palliative care consultation among patients with acute-on-chronic liver failure. JHEP Reports 2023, 6: 100976. PMID: 38274489, PMCID: PMC10808910, DOI: 10.1016/j.jhepr.2023.100976.Peer-Reviewed Original ResearchSpecialty palliative care consultationPalliative care consultationChronic liver failureFacility-level variationCare consultationsLiver failurePalliative careTime of deathACLF-3Significant facility-level variationRetrospective cohort studyTiming of consultationFacility factorsMixed-effects regression analysisQuality improvement effortsACLF gradeACLF-1ACLF-2Acute hospitalizationCohort studyIll patientsACLFGrade 3Hepatocellular carcinomaSick patientsThe Association Between Homelessness and Key Liver-Related Outcomes in Veterans With Cirrhosis
Pulaski M, Bittermann T, Taddei T, Kaplan D, Mahmud N. The Association Between Homelessness and Key Liver-Related Outcomes in Veterans With Cirrhosis. The American Journal Of Gastroenterology 2023, 119: 297-305. PMID: 37782293, DOI: 10.14309/ajg.0000000000002535.Peer-Reviewed Original ResearchInverse probability treatmentCause mortalityCohort studyCox regressionHepatocellular carcinomaProbability treatmentVeterans Health Administration patientsLiver-related outcomesTime-updated variablesLiver-related mortalityRetrospective cohort studyCause-specific mortality analysesVeterans Health AdministrationRisk regression modelsCirrhosis decompensationCirrhosis diagnosisPatient outcomesPatientsHomeless patientsHealth AdministrationMortality analysisCirrhosisMortalityDrivers of mortalityDecompensationRefractory hepatic hydrothorax is associated with increased mortality with death occurring at lower MELD-Na compared to cirrhosis and refractory ascites
Chin A, Bastaich D, Dahman B, Kaplan D, Taddei T, John B. Refractory hepatic hydrothorax is associated with increased mortality with death occurring at lower MELD-Na compared to cirrhosis and refractory ascites. Hepatology 2023, 79: 844-856. PMID: 37625139, DOI: 10.1097/hep.0000000000000577.Peer-Reviewed Original ResearchLiver-related deathRefractory hepatic hydrothoraxRefractory ascitesMELD-NaHepatic hydrothoraxHigh riskRetrospective cohort studyRA overallSecond paracentesisCohort studyPrimary outcomeSerious complicationsEligibility criteriaCirrhosisInadequate evidenceParacentesisHydrothoraxAscitesDeathPatientsTransplantationRiskMortalityParticipantsComplicationsAdherence to Tumor Board Recommendations in the Treatment of Patients with Hepatocellular Carcinoma
Cao Y, Mezzacappa C, Jaffe A, Strazzabosco M, Taddei T. Adherence to Tumor Board Recommendations in the Treatment of Patients with Hepatocellular Carcinoma. Journal Of Multidisciplinary Healthcare 2023, 16: 1531-1540. PMID: 37283950, PMCID: PMC10239642, DOI: 10.2147/jmdh.s407908.Peer-Reviewed Original ResearchMultidisciplinary liver tumor boardBarcelona Clinic Liver CancerHepatocellular carcinomaBCLC stageLocoregional therapyTreatment-naïve hepatocellular carcinomaTreatment of HCCTumor board recommendationsRetrospective cohort studyTertiary care centerChronic liver diseaseMultivariate Cox regressionKaplan-Meier analysisManagement of patientsTreatment of patientsUnifocal hepatocellular carcinomaCases of discordanceBCLC guidelinesPalliative intentTreatment discordanceUnifocal diseaseChart reviewCohort studyCurative therapyCurative treatmentUrsodeoxycholic acid is associated with a reduction in SARS‐CoV‐2 infection and reduced severity of COVID‐19 in patients with cirrhosis
John B, Bastaich D, Webb G, Brevini T, Moon A, Ferreira R, Chin A, Kaplan D, Taddei T, Serper M, Mahmud N, Deng Y, Chao H, Sampaziotis F, Dahman B. Ursodeoxycholic acid is associated with a reduction in SARS‐CoV‐2 infection and reduced severity of COVID‐19 in patients with cirrhosis. Journal Of Internal Medicine 2023, 293: 636-647. PMID: 37018129, DOI: 10.1111/joim.13630.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionCritical COVID-19Ursodeoxycholic acidPropensity scoreCOVID-19Severe acute respiratory syndrome coronavirus 2Farnesoid X receptor activityAcute respiratory syndrome coronavirus 2Human lungRespiratory syndrome coronavirus 2COVID-19-related deathsRetrospective cohort studyModerate COVID-19Symptomatic COVID-19Multivariable logistic regressionLarge national cohortSyndrome coronavirus 2Coronavirus disease 2019Angiotensin-converting enzymePotential novel targetUDCA useClinical characteristicsCohort studyVaccination statusCoronavirus 2The association between mental illness and all-cause mortality in patients with cirrhosis: a Veterans Affairs retrospective cohort study
Shaffer L, Kaplan D, Taddei T, Mahmud N. The association between mental illness and all-cause mortality in patients with cirrhosis: a Veterans Affairs retrospective cohort study. Hepatology Communications 2023, 7: e0129. PMID: 36996031, PMCID: PMC10069831, DOI: 10.1097/hc9.0000000000000129.Peer-Reviewed Original ResearchConceptsMental health diagnosesAUD/SUDCause mortalityMental health visitsRetrospective cohort studyCohort studyHealth diagnosisHealth visitsSUD diagnosisMental illnessMental health clinic visitsMental health-related diagnosisOutpatient mental health visitsOutpatient mental health careVeterans Health AdministrationHealth-related careHealth-related diagnosesClinical practice changesHealth clinic visitsMental health careClinic visitsClinic utilizationCox regressionPsychiatric comorbiditySubgroup analysisMedications for alcohol use disorder improve survival in patients with hazardous drinking and alcohol-associated cirrhosis
Rabiee A, Mahmud N, Falker C, Garcia-Tsao G, Taddei T, Kaplan D. Medications for alcohol use disorder improve survival in patients with hazardous drinking and alcohol-associated cirrhosis. Hepatology Communications 2023, 7: e0093. PMID: 36972386, PMCID: PMC10043587, DOI: 10.1097/hc9.0000000000000093.Peer-Reviewed Original ResearchConceptsAlcohol-associated cirrhosisAlcohol use disorderUse disordersCause mortalityImproved survivalPropensity scoreInpatient diagnosis codesRetrospective cohort studyCox regression analysisActive alcohol useCirrhosis decompensationCohort studyConcurrent diagnosisLiver diseasePotential confoundersDiagnosis codesVeteran outcomesCirrhosis diagnosisStrong negative predictorCirrhosisPatientsHazardous drinkingAlcohol use behaviorsCosts AssociatedAlcohol useAssociation between statin exposure and short-term mortality in patients with high-grade acute-on-chronic liver failure
Chapin S, Kaplan D, Taddei T, Mahmud N. Association between statin exposure and short-term mortality in patients with high-grade acute-on-chronic liver failure. JHEP Reports 2023, 5: 100740. PMID: 37215188, PMCID: PMC10193237, DOI: 10.1016/j.jhepr.2023.100740.Peer-Reviewed Original ResearchChronic liver failureShort-term mortalityRetrospective cohort studyStatin exposureLiver failureStatin useCohort studyLogistic regression modelsLower oddsHigh short-term mortalityVeterans Health Administration patientsDose exposureMultivariable logistic regression modelClasses of medicationsFuture prospective studiesVeterans Health AdministrationDose-dependent reductionPotential beneficial effectsStatin therapyTerm mortalityAnalytic cohortRegression modelsProspective studyReduced oddsACLF
2022
Nonselective beta blockers, hepatic decompensation, and mortality in cirrhosis: A national cohort study
Serper M, Kaplan DE, Taddei TH, Tapper EB, Cohen JB, Mahmud N. Nonselective beta blockers, hepatic decompensation, and mortality in cirrhosis: A national cohort study. Hepatology 2022, 77: 489-500. PMID: 35984731, PMCID: PMC9877112, DOI: 10.1002/hep.32737.Peer-Reviewed Original ResearchConceptsNonselective beta blockersSelective beta blockersLiver-related mortalityHepatic decompensationBeta blockersCTP classPlatelet countSubgroup analysisLiver disease etiologyLower hazardNational cohort studyNew-user designInverse probability treatmentRoutine clinical settingPrior decompensationViremia statusChild-TurcotteHCV viremiaClinical confoundersComposite outcomeCohort studyPrimary outcomeActive comparatorNational cohortDecompensationThird dose of COVID-19 mRNA vaccine appears to overcome vaccine hyporesponsiveness in patients with cirrhosis
John BV, Ferreira RD, Doshi A, Kaplan DE, Taddei TH, Spector SA, Paulus E, Deng Y, Bastaich D, Dahman B. Third dose of COVID-19 mRNA vaccine appears to overcome vaccine hyporesponsiveness in patients with cirrhosis. Journal Of Hepatology 2022, 77: 1349-1358. PMID: 36181987, PMCID: PMC9519143, DOI: 10.1016/j.jhep.2022.07.036.Peer-Reviewed Original ResearchConceptsCOVID-19 mRNA vaccinesCritical COVID-19COVID-19-related deathsThird doseMRNA vaccinesCOVID-19Propensity-matched control groupRetrospective cohort studyModerate COVID-19Symptomatic COVID-19Veterans Health AdministrationBNT-162b2BNT162b2 mRNAModerna mRNACohort studyImmune dysregulationCirrhosisSimilar riskGeneral populationMagnitude of reductionPatientsControl groupHealth AdministrationVaccineAbstractTextType of Infection Is Associated with Prognosis in Acute-on-Chronic Liver Failure: A National Veterans Health Administration Study
Mahmud N, Reddy KR, Taddei TH, Kaplan DE. Type of Infection Is Associated with Prognosis in Acute-on-Chronic Liver Failure: A National Veterans Health Administration Study. Digestive Diseases And Sciences 2022, 68: 1632-1640. PMID: 36083379, PMCID: PMC9995592, DOI: 10.1007/s10620-022-07680-9.Peer-Reviewed Original ResearchConceptsSpontaneous bacterial peritonitisChronic liver failureShort-term mortalityLiver failureHigh short-term mortalityACLF grade 3Retrospective cohort studyUrinary tract infectionMultivariable logistic regressionVeterans Health AdministrationType of infectionInverse probability treatmentLarge national databaseSource of infectionACLF gradeMSK infectionsCohort studyTract infectionsBacterial peritonitisMusculoskeletal infectionsFrequent precipitantInfectious sourceGrade 3Relative oddsHealth AdministrationComparison of infection‐induced and vaccine‐induced immunity against COVID‐19 in patients with cirrhosis
John BV, Doshi A, Ferreira RD, Taddei TH, Kaplan DE, Spector SA, Deng Y, Bastaich D, Dahman B. Comparison of infection‐induced and vaccine‐induced immunity against COVID‐19 in patients with cirrhosis. Hepatology 2022, 77: 186-196. PMID: 35712794, DOI: 10.1002/hep.32619.Peer-Reviewed Original ResearchConceptsPositive SARS-CoV-2 polymerase chain reactionVaccine-induced immunitySARS-CoV-2 infectionInfection-induced immunityImmunity groupsReduced oddsSARS-CoV-2 polymerase chain reactionCOVID-19Retrospective cohort studyCritical COVID-19Multivariable logistic regressionSARS-CoV-2Unvaccinated participantsUnvaccinated patientsFull vaccinationCohort studyCOVID-19 variantsCommunity prevalencePrevious infectionMRNA vaccinesPolymerase chain reactionUS veteransTreatment weightingCirrhosisPropensity scorePostvaccination COVID‐19 infection is associated with reduced mortality in patients with cirrhosis
John BV, Deng Y, Schwartz KB, Taddei TH, Kaplan DE, Martin P, Chao H, Dahman B. Postvaccination COVID‐19 infection is associated with reduced mortality in patients with cirrhosis. Hepatology 2022, 76: 126-138. PMID: 35023206, PMCID: PMC9015228, DOI: 10.1002/hep.32337.Peer-Reviewed Original ResearchConceptsCOVID-19 infectionCOVID-19Breakthrough COVID-19 infectionsBreakthrough COVID-19Propensity-matched cohortRetrospective cohort studyCOVID-19 patientsPfizer BNT162b2Unvaccinated participantsFull vaccinationCohort studyFirst dosePartial vaccinationMultivariable analysisSecond doseUS veteransCirrhosisReduced riskVaccine availabilityPatientsVaccinationVaccineInfectionMortalityDoseThe Association Between Proton Pump Inhibitor Exposure and Key Liver-Related Outcomes in Patients With Cirrhosis: A Veterans Affairs Cohort Study
Mahmud N, Serper M, Taddei TH, Kaplan DE. The Association Between Proton Pump Inhibitor Exposure and Key Liver-Related Outcomes in Patients With Cirrhosis: A Veterans Affairs Cohort Study. Gastroenterology 2022, 163: 257-269.e6. PMID: 35398042, PMCID: PMC10020994, DOI: 10.1053/j.gastro.2022.03.052.Peer-Reviewed Original ResearchConceptsLiver-related mortalityPPI exposureGastrointestinal bleedingCause mortalityProton pump inhibitor exposurePrior gastrointestinal bleedingTime-updated variablesCause-specific mortality analysesLarge national cohortVeterans Health AdministrationRisk of infectionCardiovascular comorbiditiesPPI useCohort studyStatin exposureCox regressionRetrospective studyAdverse outcomesAppropriate indicationsNational cohortInhibitor exposureSevere infectionsCirrhosis diagnosisAdditional adjustmentAdjusted modelStatin exposure is associated with reduced development of acute-on-chronic liver failure in a Veterans Affairs cohort
Mahmud N, Chapin S, Goldberg DS, Reddy KR, Taddei TH, Kaplan DE. Statin exposure is associated with reduced development of acute-on-chronic liver failure in a Veterans Affairs cohort. Journal Of Hepatology 2022, 76: 1100-1108. PMID: 35066085, PMCID: PMC9018495, DOI: 10.1016/j.jhep.2021.12.034.Peer-Reviewed Original ResearchConceptsChronic liver failureStatin exposureLiver failureStatin useCohort studyChronic liver failure developmentInverse probability treatment weightingProportional hazards regression modelsDoses of statinsVeterans Affairs cohortRetrospective cohort studyChronic liver diseaseHazards regression modelsLarge national cohortVeterans Health AdministrationNumerous beneficial effectsMarginal structural modelsMedian followStatin therapyLiver diseaseNational cohortACLFTreatment weightingCirrhosisPatients