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
Third 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 availabilityPatientsVaccinationVaccineInfectionMortalityDoseStatin 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
Association of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis
John BV, Deng Y, Scheinberg A, Mahmud N, Taddei TH, Kaplan D, Labrada M, Baracco G, Dahman B. Association of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis. JAMA Internal Medicine 2021, 181: 1306-1314. PMID: 34254978, PMCID: PMC8278308, DOI: 10.1001/jamainternmed.2021.4325.Peer-Reviewed Original ResearchConceptsCOVID-19 infectionCOVID-19-related hospitalizationBNT162b2 mRNAFirst doseCohort studySecond doseMRNA vaccinesClinical trialsControl groupPropensity-matched control groupPhase 3 clinical trialsCOVID-19 mRNA vaccinesAssociation of vaccinationRetrospective cohort studyUS veteran populationAssociation of receiptVeterans Health AdministrationCoronavirus disease 2019COVID-19 hospitalizationMRNA vaccine administrationCOVID-19Vaccine recipientsImmune dysregulationModerna mRNAMedian ageImpact of Obeticholic acid Exposure on Decompensation and Mortality in Primary Biliary Cholangitis and Cirrhosis
John BV, Schwartz K, Levy C, Dahman B, Deng Y, Martin P, Taddei TH, Kaplan DE. Impact of Obeticholic acid Exposure on Decompensation and Mortality in Primary Biliary Cholangitis and Cirrhosis. Hepatology Communications 2021, 5: 1426-1436. PMID: 34430786, PMCID: PMC8369937, DOI: 10.1002/hep4.1720.Peer-Reviewed Original ResearchPrimary biliary cholangitisLiver-related mortalityHepatic decompensationOCA useOCA usersPBC cirrhosisObeticholic acidPropensity score modelBiliary cholangitisScore modelRetrospective cohort studySerious liver injuryTreatment of patientsEffect of treatmentCohort studyPartial respondersLiver injuryMultivariable analysisPotential confoundersC-statisticUS veteransUrsodeoxycholic acidBaseline riskCirrhosisDecompensationFactors Associated With Access to and Receipt of Liver Transplantation in Veterans With End-stage Liver Disease
Kanwal F, Hernaez R, Liu Y, Taylor TJ, Rana A, Kramer JR, Naik AD, Smith D, Taddei T, Asch SM. Factors Associated With Access to and Receipt of Liver Transplantation in Veterans With End-stage Liver Disease. JAMA Internal Medicine 2021, 181: 949-959. PMID: 34028505, PMCID: PMC8145153, DOI: 10.1001/jamainternmed.2021.2051.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseAdvanced liver diseaseLiver diseaseLiver transplantationCohort studyMedical recordsOrgan transplantsVeterans Affairs Health Care SystemLower ratesRetrospective cohort studyWait-listed patientsAfrican American patientsComprehensive electronic medical recordsElectronic medical recordsHealth care systemReferral stepsLiver allograftsLiver transplantAdult patientsAlcohol etiologyLow annual incomePatient ageCurative therapyLiver cirrhosisSodium scoreUrsodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated Cirrhosis
John BV, Khakoo NS, Schwartz KB, Aitchenson G, Levy C, Dahman B, Deng Y, Goldberg DS, Martin P, Kaplan DE, Taddei TH. Ursodeoxycholic Acid Response Is Associated With Reduced Mortality in Primary Biliary Cholangitis With Compensated Cirrhosis. The American Journal Of Gastroenterology 2021, 116: 1913-1923. PMID: 33989225, PMCID: PMC8410631, DOI: 10.14309/ajg.0000000000001280.Peer-Reviewed Original ResearchConceptsLiver-related deathPrimary biliary cholangitisUDCA responseHepatic decompensationHepatocellular carcinomaUrsodeoxycholic acidUDCA respondersPortal hypertensionPartial respondersBiliary cholangitisTime-updated Cox proportional hazards modelsCox proportional hazards modelUrsodeoxycholic acid responseLiver-related mortalityRetrospective cohort studyProportional hazards modelPBC cirrhosisCompensated cirrhosisCohort studyMale patientsClinical benefitUnadjusted ratesCirrhosisReduced mortalityDecompensationFrailty 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 riskThe Predictive Role of Model for End‐Stage Liver Disease–Lactate and Lactate Clearance for In‐Hospital Mortality Among a National Cirrhosis Cohort
Mahmud N, Asrani SK, Kaplan DE, Ogola GO, Taddei TH, Kamath PS, Serper M. The Predictive Role of Model for End‐Stage Liver Disease–Lactate and Lactate Clearance for In‐Hospital Mortality Among a National Cirrhosis Cohort. Liver Transplantation 2021, 27: 177-189. PMID: 33025731, PMCID: PMC7880877, DOI: 10.1002/lt.25913.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseHospital mortalityLactate clearanceCirrhosis hospitalizationsMELD-NaLiver diseaseDay 1Predictive roleRetrospective cohort studyIn-Hospital MortalityRisk-stratify patientsVeterans Health AdministrationCirrhosis cohortMELD categoriesGastrointestinal bleedingCohort studyClinical dataLimited cohortStratified analysisLactate levelsHospitalizationHealth AdministrationMELDClinical toolMortality