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 cohortDecompensation
2021
Risk Prediction Models for Postoperative Decompensation and Infection in Patients With Cirrhosis: A Veterans Affairs Cohort Study
Mahmud N, Fricker Z, Lewis JD, Taddei TH, Goldberg DS, Kaplan DE. Risk Prediction Models for Postoperative Decompensation and Infection in Patients With Cirrhosis: A Veterans Affairs Cohort Study. Clinical Gastroenterology And Hepatology 2021, 20: e1121-e1134. PMID: 34246794, PMCID: PMC8741885, DOI: 10.1016/j.cgh.2021.06.050.Peer-Reviewed Original ResearchConceptsLiver diseasePostoperative decompensationPostoperative mortalityPostoperative infectionRisk scoreAlcohol-related liver diseaseEnd-stage liver diseaseMayo risk scoreSurgical risk scoresData of patientsMultivariable logistic regressionVeterans Health AdministrationRange of surgeryRisk prediction modelCirrhosis decompensationPugh scoreChild-TurcottePostoperative complicationsCohort studyPostoperative dayRetrospective studyStratify patientsVeteran outcomesDecompensationExcellent calibrationFrailty Is a Risk Factor for Postoperative Mortality in Patients With Cirrhosis Undergoing Diverse Major Surgeries
Mahmud N, Kaplan DE, Taddei TH, Goldberg DS. Frailty Is a Risk Factor for Postoperative Mortality in Patients With Cirrhosis Undergoing Diverse Major Surgeries. Liver Transplantation 2021, 27: 699-710. PMID: 33226691, PMCID: PMC8517916, DOI: 10.1002/lt.25953.Peer-Reviewed Original ResearchConceptsMayo risk scoreHospital Frailty Risk ScorePostoperative mortalityPatient frailtyRisk scoreMELD-NaMajor surgeryLiver diseaseRisk factorsEnd-stage liver diseaseFrailty Risk ScorePreoperative frailty assessmentRetrospective cohort studySurgical risk scoresMajority of patientsCox regression modelPoor postoperative survivalRisk prediction modelAdditional important predictorChild-TurcotteFrailty assessmentFrailty scorePostoperative survivalCohort studyPostoperative riskRisk Prediction Models for Post‐Operative Mortality in Patients With Cirrhosis
Mahmud N, Fricker Z, Hubbard RA, Ioannou GN, Lewis JD, Taddei TH, Rothstein KD, Serper M, Goldberg DS, Kaplan DE. Risk Prediction Models for Post‐Operative Mortality in Patients With Cirrhosis. Hepatology 2021, 73: 204-218. PMID: 32939786, PMCID: PMC7902392, DOI: 10.1002/hep.31558.Peer-Reviewed Original ResearchConceptsMayo risk scoreVeterans Affairs Surgical Quality Improvement ProgramEnd-stage liver diseaseLiver diseaseSurgical proceduresMELD-NaPostoperative mortalitySurgical Quality Improvement ProgramLiver disease cohortSurgical risk modelsPost-operative mortalityRetrospective cohort studyFatty liver diseasePreoperative risk stratificationMultivariable logistic regressionU.S. medical centersQuality Improvement ProgramRisk prediction modelPopulation-level dataPugh scoreAnesthesiologists classificationChild-TurcottePreoperative albuminCohort studyPostoperative risk
2019
Effects of Hypercholesterolemia and Statin Exposure on Survival in a Large National Cohort of Patients With Cirrhosis
Kaplan DE, Serper M, Mehta R, Fox R, John B, Aytaman A, Baytarian M, Hunt K, Albrecht J, Njei B, Taddei TH, Group V. Effects of Hypercholesterolemia and Statin Exposure on Survival in a Large National Cohort of Patients With Cirrhosis. Gastroenterology 2019, 156: 1693-1706.e12. PMID: 30660733, DOI: 10.1053/j.gastro.2019.01.026.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, HepatocellularCholesterolFemaleHeart FailureHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaLiver CirrhosisLiver NeoplasmsMaleMiddle AgedMyocardial InfarctionPropensity ScoreProportional Hazards ModelsRandomized Controlled Trials as TopicRetrospective StudiesStrokeSurvival RateUnited StatesConceptsRetrospective cohort studyStatin exposureLarge national cohortHepatic decompensationStatin useCohort studyHazard ratioNational cohortMultivariable Cox proportional hazards modelsCox proportional hazards modelBaseline total cholesterolPrior statin exposureStatin-naïve subjectsEffect of hypercholesterolemiaVeterans Health AdministrationProportional hazards modelHepatocellular carcinoma developmentDecrease of mortalityRisk-set matchingChild-TurcottePugh classStatin therapyDL increaseTotal cholesterolHepatic function
2018
Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma
Kaplan DE, Mehta R, D’Addeo K, Valderrama A, Taddei TH. Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma. Medicine 2018, 97: e9757. PMID: 29369224, PMCID: PMC5794408, DOI: 10.1097/md.0000000000009757.Peer-Reviewed Original ResearchConceptsAdvanced hepatocellular carcinomaHepatocellular carcinomaOverall survivalBarcelona Clinic Liver Cancer (BCLC) systemManagement of HCCVeterans Health Administration hospitalsRetrospective cohort studyFirst-line therapySimilar survival outcomesChild-TurcottePugh scoreComorbidity indexChart abstractionCohort studySurvival benefitSystemic therapyBCLC stagePrimary outcomePrescriber typeSurvival outcomesAdministration HospitalMultivariable modelProvider specialtyCancer stagingHCC diagnosis
2017
Starting Dose of Sorafenib for the Treatment of Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study
Reiss KA, Yu S, Mamtani R, Mehta R, D'Addeo K, Wileyto EP, Taddei TH, Kaplan DE. Starting Dose of Sorafenib for the Treatment of Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study. Journal Of Clinical Oncology 2017, 35: jco.2017.73.824. PMID: 28872925, PMCID: PMC5662845, DOI: 10.1200/jco.2017.73.8245.Peer-Reviewed Original ResearchConceptsSorafenib patientsHazard ratioOverall survivalHepatocellular carcinomaPotential confoundersNoninferiority marginEnd-stage liver disease-sodium (MELD-Na) scoreVeterans Health Administration hospitalsHigher Child-TurcottePotential treatment biasReduced pill burdenComorbidity Index scorePrimary end pointFirst-line therapyGastrointestinal adverse effectsDose of sorafenibSignificant OS differenceAdvanced hepatocellular carcinomaLower overall survivalMultivariate logistic regressionMulti-institutional studyChild-TurcotteOS relativePugh scorePurpose SorafenibComparing Child-Pugh, MELD, and FIB-4 to Predict Clinical Outcomes in Hepatitis C Virus-Infected Persons: Results From ERCHIVES
Butt AA, Ren Y, Re V, Taddei T, Kaplan DE. Comparing Child-Pugh, MELD, and FIB-4 to Predict Clinical Outcomes in Hepatitis C Virus-Infected Persons: Results From ERCHIVES. Clinical Infectious Diseases 2017, 65: 64-72. PMID: 28369305, DOI: 10.1093/cid/cix224.Peer-Reviewed Original ResearchConceptsHCV-positive personsHepatic decompensationFIB-4 scoreHuman immunodeficiency virusFIB-4Hepatocellular carcinomaCause mortalityLower riskHCV diagnosisClinical outcomesHepatitis C virus-infected personsHepatitis B surface antigenCohort of HCVVirus-infected personsB surface antigenHepatitis C virusChild-TurcotteChild-PughEarly complicationsMELD scoreImmunodeficiency virusC virusIncidence ratePositive personsTreatment decisionsSorafenib for hepatocellular carcinoma managed by non-oncologists: Impact on drug exposure and survival.
Kaplan D, Taddei T, Mehta R, D'Addeo K, Aytaman A, Hunt K, Fox R, Baytarian M, Valdarrama A. Sorafenib for hepatocellular carcinoma managed by non-oncologists: Impact on drug exposure and survival. Journal Of Clinical Oncology 2017, 35: 404-404. DOI: 10.1200/jco.2017.35.4_suppl.404.Peer-Reviewed Original ResearchICD9 codesBarcelona Clinic Liver Cancer stageOverall median survival rateInitial dosing regimensLiver Cancer stageMedian survival rateSimilar treatment durationCTP AECOG PSExtrahepatic spreadChild-TurcotteMacrovascular invasionMELD scorePrescriber specialtyReal-world practiceMedian agePharmacy recordsSorafenib exposureBCLC 0Dosing regimensLiver diseaseTumor numberPrescribing practicesHCC patientsCancer stageUp-titration of sorafenib for hepatocellular carcinoma: Impact on duration of exposure and cost.
Kaplan D, Yu S, Taddei T, Reiss K, Mehta R, D'Addeo K, Aytaman A, Hunt K, Fox R, Baytarian M, Valdarrama A. Up-titration of sorafenib for hepatocellular carcinoma: Impact on duration of exposure and cost. Journal Of Clinical Oncology 2017, 35: 385-385. DOI: 10.1200/jco.2017.35.4_suppl.385.Peer-Reviewed Original ResearchDuration of exposureBCLC BICD9 codesBarcelona Clinic Liver Cancer stageInitiation of sorafenibMedian overall survivalLiver Cancer stageLonger exposure durationECOG PSExposure durationUp-titrationChild-TurcotteMELD scoreSorafenib therapyFirst doseOverall survivalPharmacy recordsMedian agePrescription fillsLiver diseaseTumor numberC-HCCEquivalent survivalHCC patientsCancer stage
2016
Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis
Kaplan DE, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Knott A, Mehta R, Pedrosa M, Pocha C, Valderrama A, Taddei T, for the VOCAL Study Group. Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis. Digestive Diseases And Sciences 2016, 61: 3309-3320. PMID: 27405990, PMCID: PMC5067291, DOI: 10.1007/s10620-016-4239-6.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBilirubinCreatinineDisease ProgressionEnd Stage Liver DiseaseEvidence-Based MedicineFemaleHumansInternational Normalized RatioLiver CirrhosisLiver TransplantationMaleMiddle AgedOdds RatioPrognosisProportional Hazards ModelsRetrospective StudiesSerum AlbuminSeverity of Illness IndexUnited StatesVeteransConceptsTransplant-free survivalHarrell's C-statisticC-statisticPugh scoreChild-TurcotteCTP scoreHighest Harrell's C-statisticsCox proportional hazards modelEvidence-based cutpointProportional hazards modelLong-term survivalEtiology subgroupsSerum creatinineVeteran patientsLaboratory variablesRisk ratioTotal bilirubinHazards modelCirrhosisPatientsLower cutpointsDisease etiologySurvivalCutpointsScores
2015
Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database
Kaplan DE, Dai F, Aytaman A, Baytarian M, Fox R, Hunt K, Knott A, Pedrosa M, Pocha C, Mehta R, Duggal M, Skanderson M, Valderrama A, Taddei TH, Group V. Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database. Clinical Gastroenterology And Hepatology 2015, 13: 2333-2341.e6. PMID: 26188137, PMCID: PMC4655141, DOI: 10.1016/j.cgh.2015.07.010.Peer-Reviewed Original ResearchConceptsCTP scoreAdministrative databasesChild-TurcottePugh scoreVeterans Health Administration Corporate Data WarehouseLaboratory dataCox proportional hazards regressionSeverity of ascitesTransplant-free survivalSeverity IndexInternational normalized ratioClinical laboratory valuesHarrell's C-statisticProportional hazards regressionDiseases version 9U.S. Veterans Health AdministrationVeterans Health AdministrationMulticenter collaborative studyLarge administrative databaseLong-term survivalDisease severity scoreValidity of diagnosesCorporate Data WarehouseElectronic healthcare databasesCommon Procedural Terminology