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cirrhosis readmission

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https://www.readbyqxmd.com/read/29150405/cirrhosis-with-ascites-in-the-last-year-of-life-a-nationwide-analysis-of-factors-shaping-costs-health-care-use-and-place-of-death-in-england
#1
Benjamin Hudson, Jeff Round, Brendan Georgeson, Andrew Pring, Karen Forbes, Catherine Anne McCune, Julia Verne
BACKGROUND: Liver disease mortality increased by 400% in the UK between 1970 and 2010, resulting in rising pressures on acute hospital services, and an increasing need for end-of-life care. We aimed to assess the effect of demographic, clinical, and health-care factors on costs, patterns of health-care use, and place of death in a national cohort of patients with cirrhosis and ascites in their last year of life. METHODS: We did a retrospective, nationwide analysis of all patients who died from cirrhosis in England between 2013 and 2015, who required large-volume paracentesis in their last year of life...
November 14, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28918191/development-and-validation-of-a-chronic-pancreatitis-prognosis%C3%A2-score-in-2-independent-cohorts
#2
Georg Beyer, Ujjwal M Mahajan, Christoph Budde, Thomas J Bulla, Thomas Kohlmann, Louise Kuhlmann, Kerstin Schütte, Ali A Aghdassi, Eckhard Weber, Ulrich Weiss, Asbjørn M Drewes, Søren S Olesen, Markus M Lerch, Julia Mayerle
BACKGROUND & AIMS: The clinical course of chronic pancreatitis is unpredictable. There is no model to assess disease severity or progression or predict patient outcomes. METHODS: We performed a prospective study of 91 patients with chronic pancreatitis; data were collected from patients seen at academic centers in Europe from January 2011 through April 2014. We analyzed correlations between clinical, laboratory, and imaging data with number of hospital readmissions and in-hospital days over the next 12 months; the parameters with the highest degree of correlation were to develop 3-stage chronic pancreatitis prognosis score (COPPS)...
September 14, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28870446/hepacontrol-a-program-that-reduces-early-readmissions-mortality-at-60-days-and-healthcare-costs-in-decompensated-cirrhosis
#3
Betty P Morales, Ramon Planas, Ramon Bartoli, Rosa M Morillas, Margarita Sala, Irma Casas, Carolina Armengol, Helena Masnou
BACKGROUND & AIMS: Decompensated cirrhosis patients have an elevated incidence of early readmission, mortality and economic burden. The aims of HEPACONTROL were to reduce early readmission and to evaluate its impact on mortality and emergency department visits. PATIENTS AND METHODS: Quasi-experimental study with control group which compared two cohorts of patients discharged after being admitted for cirrhosis-related complications. A prospective cohort (n=80), who followed the HEPACONTROL program, which began with a follow-up examination seven days after discharge at the Hepatology Unit Day Hospital and a retrospective cohort of patients (n=112), who had been given a standard follow-up...
August 13, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28858068/inflammatory-bowel-disease-predictors-and-causes-of-early-and-late-hospital-readmissions
#4
Prashant Mudireddy, Frank Scott, Alexandra Feathers, Gary R Lichtenstein
BACKGROUND AND AIMS: The rate of hospital readmission after discharge has been studied extensively in chronic conditions such as hepatic cirrhosis, diabetes mellitus, chronic obstructive pulmonary disease, and heart failure. Causative factors associated with hospital readmission have not been adequately investigated in patients with inflammatory bowel disease (IBD). We studied the rate, causes, and factors that predict readmissions at 1 month, 3 months, and 1 year in patients with IBD...
August 29, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28853729/predictors-of-early-readmission-in-patients-with-cirrhosis-after-the-resolution-of-bacterial-infections
#5
Salvatore Piano, Filippo Morando, Giovanni Carretta, Marta Tonon, Elia Vettore, Silvia Rosi, Marialuisa Stanco, Chiara Pilutti, Antonietta Romano, Alessandra Brocca, Antonietta Sticca, Daniele Donato, Paolo Angeli
OBJECTIVES: In patients with cirrhosis, infections represent a frequent trigger for complications, increasing frequency of hospitalizations and mortality rate. This study aimed to identify predictors of early readmission (30 days) and of mid-term mortality (6 months) in patients with liver cirrhosis discharged after a hospitalization for bacterial and/or fungal infection. METHODS: A total of 199 patients with cirrhosis discharged after an admission for a bacterial and/or fungal infection were included in the study and followed up for a least 6 months...
October 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28846185/outcomes-and-readmissions-after-transcatheter-and-surgical-aortic-valve-replacement-in-patients-with-cirrhosis-a-propensity-matched-analysis
#6
Abhijeet Dhoble, Viraj Bhise, Moises I Nevah, Prakash Balan, Tom C Nguyen, Anthony L Estrera, Richard W Smalling
BACKGROUND: The data on the comparative outcomes and readmissions after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with cirrhosis are limited. We compared mortality, complications, discharge disposition, 30-day readmission rates, length of stay, and cost of hospitalization in cirrhotic patients undergoing TAVR and SAVR. METHODS: The National Inpatient Sample (NIS) and the National Readmission Database (NRD) were used for the study...
August 28, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28820039/sepsis-at-a-safety-net-hospital-risk-factors-associated-with-30-day-readmission
#7
Mark A Weinreich, Kim Styrvoky, Shelley Chang, Carlos E Girod, Rosechelle Ruggiero
BACKGROUND: Sepsis is a leading cause of hospitalization, and subsequent readmissions are frequent and costly. There is an expanding body of literature describing risk factors for readmissions in patients with sepsis. However, there are little data studying medically underserved patients who typically receive their care at a safety net hospital. METHODS: In a retrospective cohort study, we evaluated 1355 sepsis survivors at risk of hospital readmission in fiscal year 2013 at a safety net hospital...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28737647/risk-factors-for-30-day-hospital-readmission-for-diverticular-hemorrhage
#8
Jonah N Rubin, Daniel Shoag, John N Gaetano, Dejan Micic, Neil Sengupta
INTRODUCTION: The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding. MATERIALS AND METHODS: We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28618192/the-patient-buddy-app-can-potentially-prevent-hepatic-encephalopathy-related-readmissions
#9
Dinesh Ganapathy, Chathur Acharya, Jatinder Lachar, Kavish Patidar, Richard K Sterling, Melanie B White, Catherine Ignudo, Swamy Bommidi, John DeSoto, Leroy R Thacker, Scott Matherly, Jawaid Shaw, Mohammad S Siddiqui, Puneet Puri, Arun J Sanyal, Velimir Luketic, Hannah Lee, Richard T Stravitz, Jasmohan S Bajaj
BACKGROUND & AIMS: Readmissions are a major burden in cirrhosis. A proportion of readmissions in cirrhosis, especially because of hepatic encephalopathy (HE) could be avoided through patient and caregiver engagement. We aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. METHODS: Cirrhotic inpatients with caregivers were enrolled and followed for 30 days post-discharge...
December 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28586116/fecal-microbiota-transplant-from-a-rational-stool-donor-improves-hepatic-encephalopathy-a-randomized-clinical-trial
#10
Jasmohan S Bajaj, Zain Kassam, Andrew Fagan, Edith A Gavis, Eric Liu, I Jane Cox, Raffi Kheradman, Douglas Heuman, Jessica Wang, Thomas Gurry, Roger Williams, Masoumeh Sikaroodi, Michael Fuchs, Eric Alm, Binu John, Leroy R Thacker, Antonio Riva, Mark Smith, Simon D Taylor-Robinson, Patrick M Gillevet
Recurrent hepatic encephalopathy (HE) is a leading cause of readmission despite standard of care (SOC) associated with microbial dysbiosis. Fecal microbiota transplantation (FMT) may improve dysbiosis; however, it has not been studied in HE. We aimed to define whether FMT using a rationally derived stool donor is safe in recurrent HE compared to SOC alone. An open-label, randomized clinical trial with a 5-month follow-up in outpatient men with cirrhosis with recurrent HE on SOC was conducted with 1:1 randomization...
December 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28410915/early-hospital-readmission-in-decompensated-cirrhosis-incidence-impact-on-mortality-and-predictive-factors
#11
Betty P Morales, Ramon Planas, Ramon Bartoli, Rosa M Morillas, Margarita Sala, Eduard Cabré, Irma Casas, Helena Masnou
BACKGROUND & AIMS: The early hospital readmission of patients with decompensated cirrhosis is a current problem. A study is presented on the incidence, the impact on mortality, and the predictive factors of early hospital readmission. PATIENTS AND METHODS: On the study included 112 cirrhotic patients, discharged after some decompensation between January 2013 and May 2014. Multivariate analyses were performed to identify predictors of early readmission and mortality...
August 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28383303/early-hospital-readmissions-and-mortality-in-patients-with-decompensated-cirrhosis-enrolled-in-a-large-national-health-insurance-administrative-database
#12
Steven J Scaglione, Leanne Metcalfe, Stephanie Kliethermes, Ivan Vasilyev, Rebecca Tsang, Allyce Caines, Shaham Mumtaz, Vik Goyal, Asra Khalid, David Shoham, Talar Markossian, Amy Luke, Howard Underwood, Scott J Cotler
BACKGROUND: Patients with decompensated cirrhosis have high rates of morbidity and mortality and frequently require hospital admission. Few studies have examined early readmission as an indicator of 90 day and overall mortality. Analysis of large databases is needed to evaluate the association between early readmission and mortality in decompensated cirrhosis. METHODS: We analyzed 5 years of private, employer-based, health insurance claims data associated with HealthCare Services Corporation on 13...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28288193/nonalcoholic-fatty-liver-disease-and-increased-risk-of-1-year-all-cause-and-cardiac-hospital-readmissions-in-elderly-patients-admitted-for-acute-heart-failure
#13
Filippo Valbusa, Stefano Bonapace, Davide Agnoletti, Luca Scala, Cristina Grillo, Pietro Arduini, Emanuela Turcato, Alessandro Mantovani, Giacomo Zoppini, Guido Arcaro, Christopher Byrne, Giovanni Targher
Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for heart failure (HF). Although some progress has been made in improving survival among patients admitted for HF, the rates of hospital readmissions and the related costs continue to rise dramatically. We sought to examine whether NAFLD and its severity (diagnosed at hospital admission) was independently associated with a higher risk of 1-year all-cause and cardiac re-hospitalization in patients admitted for acute HF. We studied 212 elderly patients who were consecutively admitted with acute HF to the Hospital of Negrar (Verona) over a 1-year period...
2017: PloS One
https://www.readbyqxmd.com/read/28245467/hospitalizations-due-to-cirrhosis-clinical-aspects-in-a-large-cohort-of-italian-patients-and-cost-analysis-report
#14
Marco Di Pascoli, Elena Ceranto, Paolo De Nardi, Daniele Donato, Angelo Gatta, Paolo Angeli, Patrizia Pontisso
BACKGROUND AND AIM: Liver cirrhosis is characterized by high morbidity and mortality rates. This study was addressed to evaluate the epidemiological and economic impact of cirrhosis on hospitalizations in a large population in Italy. METHODS: Epidemiological analysis was performed using hospital discharge sheets of 57,720 hospitalizations due to liver disease from 2006 to 2008, selected from the Veneto regional archive. In a sample of 100 randomly selected hospitalizations, a detailed cost analysis was performed and a comparison was made with sets of patients admitted for heart failure (HF) and chronic obstructive pulmonary disease (COPD)...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28163280/long-term-outcome-of-cardiac-surgery-in-1-040-liver-cirrhosis-patient%C3%A3-nationwide-population-based-cohort-study
#15
An-Hsun Chou, Tien-Hsing Chen, Chun-Yu Chen, Shao-Wei Chen, Chao-Wei Lee, Chien-Hung Liao, Shang-Yu Wang
BACKGROUND: Patients with liver cirrhosis (LC) have a higher risk for cardiac surgery, but population-based long-term follow-up studies are lacking. The aim of this study was therefore to validate the long-term outcome of cardiac surgery in patients with LC.Methods and Results:Data were obtained from Taiwan's National Health Insurance Database, 1997-2011. This study included 1,040 LC patients and 1,040 matched controls without LC. The actuarial survival rate at 1, 5 and 10 years in the LC cohort was 68%, 50% and 41%: significantly lower than that of the control cohort at 81%, 68% and 62% at 1, 5 and 10 years after cardiac surgery...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28163089/comparative-effectiveness-of-minimally-invasive-surgery-and-conventional-approaches-for-major-or-challenging-hepatectomy
#16
COMPARATIVE STUDY
Lucas W Thornblade, Xu Shi, Alex Ruiz, David R Flum, James O Park
BACKGROUND: The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. STUDY DESIGN: We conducted a retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014...
May 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28101791/strategies-to-reduce-30-day-readmissions-in-patients-with-cirrhosis
#17
REVIEW
Elliot B Tapper, Michael Volk
PURPOSE OF REVIEW: Approximately, one quarter of patients discharged after a hospitalization for decompensated cirrhosis will be readmitted within 30 days. These readmissions have been associated with increased morbidity and mortality, can be financially harmful to the health system, and may be partially preventable. This review summarizes the literature on readmissions, providing clinicians with tools for risk prediction and a taxonomy for preventative interventions. RECENT FINDINGS: Readmission strategies can be categorized according to complexity (simple versus complex) and specificity (focused versus broad)...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28090224/computerized-tomography-guided-paracentesis-an-effective-alternative-to-bedside-paracentesis
#18
Vinaya Gaduputi, Hassan Tariq, Chaitanya Chandrala, Sailaja Sakam, Naeem Abbas, Sridhar Chilimuri
BACKGROUND: Ascites remains the most common cause of hospitalization among patients with decompensated cirrhosis. Paracentesis is a relatively safe procedure with low complication rates. Computerized tomography (CT)-guided therapeutic paracentesis could be a safe and effective alternative to unaided or aided (ultrasonogram-guided) bedside paracentesis. In this retrospective study, we aimed to compare the efficacy, safety, and cost-effectiveness of CT-guided paracentesis with bedside paracentesis...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27868217/chronic-opioid-use-is-associated-with-altered-gut-microbiota-and-predicts-readmissions-in-patients-with-cirrhosis
#19
C Acharya, N S Betrapally, P M Gillevet, R K Sterling, H Akbarali, M B White, D Ganapathy, A Fagan, M Sikaroodi, J S Bajaj
BACKGROUND: Opioid use is epidemic in cirrhosis, which could precipitate hepatic encephalopathy (HE) potentially through gut dysbiosis and inflammation. AIM: To define the effect of opioids on readmissions and on gut microbiota composition and functionality. METHODS: Cohort 1 had 200 cirrhotic in-patients (with/without opioid use) followed prospectively through the index hospitalisation and 6 months post discharge. Readmissions (HE-related/unrelated) were compared between patients discharged on opioids compared to the rest, including using a multi-variable analysis...
January 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27763575/optimal-treatment-of-hepatic-encephalopathy
#20
Sanath Allampati, Kevin D Mullen
Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome associated with decompensated liver disease. The spectrum of disease ranges from trivial abnormalities in complex decision-making and prolonged reaction time to coma in its most severe form. The very initial stages, recently termed covert hepatic encephalopathy, can only be diagnosed with the help of neuropsychiatric testing, while the later and more severe forms, termed overt hepatic encephalopathy, can be diagnosed clinically. Management of HE is very critical as it can dramatically increase morbidity and mortality...
December 2016: Minerva Gastroenterologica e Dietologica
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