Non-selective beta-blockers control ascites and improve outcomes in cirrhotic patients with first episode of ascites

The use of non-selective beta-blockers (NSBBs) in patients with compensated cirrhosis has been shown to reduce the risk of first decompensation. However, their role after initial hydroptic decompensation is not clearly defined. This study aimed to evaluate the clinical evolution of patients with cirrhosis after the first episode of ascites.

Inpatients with first decompensation in the form of ascites between January 2013 and January 2023 were included. Clinical variables and outcomes were compared between patients treated with and without NSBBs.

A total of 99 patients were included, of whom 47 (47.5%) received NSBBs. Control of ascites was improved in the NSBB group (70.2% vs. 46.2%, P = 0.02), with an adjusted odds ratio of 6.12 (P < 0.01). A trend toward lower frequency of liver-related events, hospitalization, and overall mortality was observed in the NSBB group, though not statistically significant. Liver-related mortality was lower in the adjusted analysis (hazard ratio = 0.22, P = 0.04).

Treatment with NSBBs after the first hydroptic decompensation was associated with improved ascites control and may have a favorable impact on clinical outcomes. These findings should be interpreted with caution and highlight the need for prospective studies.