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Letter
Lack of consensus for usage of β-blockers in end-stage liver disease
  1. Katrine H Thorhauge1,2,
  2. Katrine P Lindvig1,2,
  3. Wim Laleman3,
  4. Paolo Angeli4,
  5. Shivaram P Singh5,
  6. Aleksander Krag1,2
  1. 1 Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark
  2. 2 OPEN, Odense Patient data Exploratory Network, Odense University Hospital, Odense, Denmark
  3. 3 Department of Liver and Biliopancreatic Disorders, University Hospitals Leuven, KU Leuven, Belgium
  4. 4 Unit of Hepatic Emergencies and Liver Transplantation, Department of Medicine (DIMED), University of Padova, Padova, Italy
  5. 5 Department of Gastroenterology, Medical College, Cuttack, Odisha, India
  1. Correspondence to Professor Aleksander Krag, Department of Gastroenterology and Hepatology, Odense University Hospital, Sdr. Boulevard 29, Entrance 126, Odense 5000, Denmark; Aleksander.krag{at}rsyd.dk

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The decision of ‘if and when’ to stop non-selective β-blockers (NSBB) at certain stages of end-stage cirrhosis has been debated intensively and has generated a number of studies with various outcomes.1 ,2 Some studies demonstrated deleterious effects, others improved survival.3 ,4 However, nobody has looked into how these conflicting findings influence doctors and today’s clinical practice when prescribing NSBB.

Our hypothesis is that this ongoing controversy causes an unstandardised usage of NSBB depending on the individual clinician. To test this, we performed a survey consisting of 131 branched questions regarding the usage of NSBB in advanced cirrhosis. It was structured with potential contraindications or adverse events and the respondents were asked if they considered these as contraindications or not. Furthermore, they were questioned if NSBB should be reinstituted if the condition improved. The survey was subdivided in a …

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