2023
HCC is associated with diabetes and longitudinal blood glucose control in a national cohort with cirrhosis
Mezzacappa C, Mahmud N, Serper M, John B, Taddei T, Kaplan D. HCC is associated with diabetes and longitudinal blood glucose control in a national cohort with cirrhosis. Hepatology Communications 2023, 7: e0344. PMID: 38055642, PMCID: PMC10984661, DOI: 10.1097/hc9.0000000000000344.Peer-Reviewed Original ResearchRate of HCCBlood glucose controlBG controlIncident HCCGlucose controlCox proportional hazards regressionEtiology of cirrhosisProportional hazards regressionUnited States veteransHemoglobin A1c measurementsCirrhosis careHgb A1cHCC ratesHazards regressionNational cohortHCC riskA1c measurementStates veteransCirrhosisHigh riskDiabetesSustained controlHCCControl stateCohort
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 cohortDecompensationPatterns of Care Utilization and Hepatocellular Carcinoma Surveillance: Tracking Care Across the Pandemic
Serper M, Tapper EB, Kaplan DE, Taddei TH, Mahmud N. Patterns of Care Utilization and Hepatocellular Carcinoma Surveillance: Tracking Care Across the Pandemic. The American Journal Of Gastroenterology 2022, 118: 294-303. PMID: 36114778, PMCID: PMC9898115, DOI: 10.14309/ajg.0000000000002011.Peer-Reviewed Original ResearchConceptsOutpatient primary care providerHepatocellular carcinoma surveillancePrimary care providersHCC surveillanceCare providersHCC surveillance ratesGastroenterology/hepatologyFacility-level variablesCirrhosis cohortPatient demographicsClinical factorsTotal cohortCare utilizationNational cohortOutpatient utilizationSpecialty careInpatient careMultivariable modelPercentage of timePopulation-based approachSurveillance ratesAppointment ratesAdjusted modelVisit ratesCoronavirus diseaseThe 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
2021
Inpatient Gastroenterology Consultation and Outcomes of Cirrhosis-Related Hospitalizations in Two Large National Cohorts
Serper M, Kaplan DE, Lin M, Taddei TH, Parikh ND, Werner RM, Tapper EB. Inpatient Gastroenterology Consultation and Outcomes of Cirrhosis-Related Hospitalizations in Two Large National Cohorts. Digestive Diseases And Sciences 2021, 67: 2094-2104. PMID: 34374917, PMCID: PMC10849043, DOI: 10.1007/s10620-021-07150-8.Peer-Reviewed Original ResearchConceptsLength of stayPropensity-matched analysisNational cohortSpecialty careHigher LOSAlcohol-associated hepatitisCirrhosis-related admissionsOutcome of cirrhosisSpontaneous bacterial peritonitisLarge national cohortCirrhosis complicationsHepatology consultationVA cohortIndex admissionGastroenterology consultationClinical characteristicsBacterial peritonitisLiver diseaseReadmission riskICD9/10 codesRisk regressionInpatient consultationsPatientsLower mortalityDisease severity
2020
Effects of Metformin Exposure on Survival in a Large National Cohort of Patients With Diabetes and Cirrhosis
Kaplan DE, Serper M, John BV, Tessiatore KM, Lerer R, Mehta R, Fox R, Aytaman A, Baytarian M, Hunt K, Albrecht J, Taddei TH, Group V. Effects of Metformin Exposure on Survival in a Large National Cohort of Patients With Diabetes and Cirrhosis. Clinical Gastroenterology And Hepatology 2020, 19: 2148-2160.e14. PMID: 32798709, DOI: 10.1016/j.cgh.2020.08.026.Peer-Reviewed Original ResearchConceptsDiagnosis of cirrhosisEnzyme inhibitors/angiotensinMetformin exposureHepatic decompensationHepatocellular carcinomaDiabetes mellitusPrognosis of cirrhosisPropensity-matched approachPre-existing diabetesRetrospective cohort studyLarge national cohortVeterans Health AdministrationMarginal structural modelsConcomitant statinCohort studyMultiple medicationsStatin exposureNational cohortCirrhosisPatientsDiabetesDecompensationMetforminConcomitant exposureHealth Administration
2019
Quality Measures, All‐Cause Mortality, and Health Care Use in a National Cohort of Veterans With Cirrhosis
Serper M, Kaplan DE, Shults J, Reese PP, Beste LA, Taddei TH, Werner RM. Quality Measures, All‐Cause Mortality, and Health Care Use in a National Cohort of Veterans With Cirrhosis. Hepatology 2019, 70: 2062-2074. PMID: 31107967, PMCID: PMC6864236, DOI: 10.1002/hep.30779.Peer-Reviewed Original ResearchConceptsHealth care useHepatocellular carcinoma surveillanceCause mortalityCare useVariceal surveillanceQuality improvement effortsPostdischarge careNational cohortSpecialty careOutpatient accessFuture quality improvement effortsLiver disease cohortUpper gastrointestinal bleedingLarge national cohortGastrointestinal bleedingMean followAdjusted analysisHigh morbidityRetrospective studyDomains of accessVeteran outcomesStandardized quality measuresInpatient careDisease cohortHigh adherenceEffects 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