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cirrhosis readmission

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https://www.readbyqxmd.com/read/29601652/comparison-of-clinical-outcomes-between-variceal-and-non-variceal-gastrointestinal-bleeding-in-patients-with-cirrhosis
#1
Parul Tandon, Kirles Bishay, Stacey Fisher, Dominique Yelle, Ian Carrigan, Krista Wooller, Erin Kelly
BACKGROUND AND AIM: Acute upper gastrointestinal bleeding (UGIB) in cirrhosis is associated with significant morbidity and mortality and can be classified as acute variceal bleeding (AVB) or non-variceal bleeding (NVB). Differences in mortality, hospital length of stay (LOS) and 30-day readmission have yet to be determined. As such, we aimed to evaluate differences in these clinical outcomes in cirrhotic patients admitted with UGIB. METHODS: This retrospective study included all cirrhotic patients hospitalized for UGIB who underwent upper endoscopy from July 2014 to July 2016...
March 30, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29579356/the-high-burden-of-alcoholic-cirrhosis-in-privately-insured-persons-in-the-united-states
#2
Jessica L Mellinger, Kerby Shedden, Gerald Scott Winder, Elliot Tapper, Megan Adams, Robert J Fontana, Michael L Volk, Frederic C Blow, Anna Sf Lok
BACKGROUND AND AIMS: Alcoholic cirrhosis (AC) is a major cause of liver-related morbidity and mortality in the United States (US). Rising rates of alcohol use disorders in the US will likely result in more alcoholic liver disease. Our aim was to determine the prevalence, healthcare utilization, and costs of AC among privately insured persons in the US. METHODS: We collected data from persons aged 18-64 with AC (identified by ICD-9/ICD-10 codes) enrolled in the Truven MarketScan Commercial Claims and Encounters database (2009-2015)...
March 26, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29512261/initial-experience-with-robotic-hepatectomy-in-singapore-analysis-of-48-resections-in-43-consecutive-patients
#3
Brian K P Goh, Lip-Seng Lee, Ser-Yee Lee, Pierce K H Chow, Chung-Yip Chan, Adrian K H Chiow
BACKGROUND: Presently, the adoption of laparoscopic hepatectomy is rapidly increasingly worldwide. However, the application of robotic hepatectomy (RH) remains limited and its role remains undefined today. METHODS: A retrospective review of 43 consecutive patients who underwent RH at two institutions in the Singapore Health Services Group. RESULTS: Forty-three consecutive patients underwent 48 resections during the study period. Seven (16...
March 7, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29507899/exploring-opportunities-to-prevent-cirrhosis-admissions-in-the-emergency-department-a-multicenter-multidisciplinary-survey
#4
Shazia Mehmood Siddique, Meghan Lane-Fall, Matthew J McConnell, Neha Jakhete, James Crismale, Stefanie Porges, Vandana Khungar, Shivan J Mehta, David Goldberg, Zhiping Li, Thomas Schiano, Linda Regan, Clinton Orloski, Judy A Shea
Patients with cirrhosis have high admission and readmission rates, and it is estimated that a quarter are potentially preventable. Little data are available regarding nonmedical factors impacting triage decisions in this patient population. This study sought to explore such factors as well as to determine provider perspectives on low-acuity clinical presentations to the emergency department, including ascites and hepatic encephalopathy. A survey was distributed in four liver transplant centers to both emergency medicine and hepatology providers, who included attending physicians, house staff, and advanced practitioners; 196 surveys were returned (estimated response rate 50...
March 2018: Hepatology communications
https://www.readbyqxmd.com/read/29457210/hospital-cirrhosis-volume-and-readmission-in-patients-with-cirrhosis-in-california
#5
Mike Wei, Jason Ford, Qihan Li, Donghak Jeong, Allison J Kwong, Mindie H Nguyen, Matthew S Chang
BACKGROUND: Patients with cirrhosis are at high readmission risk. Using a large statewide database, we evaluated the effect of hospital cirrhosis-related patient volume on 30-day readmissions in patients with cirrhosis. METHODS: We conducted a retrospective study of the Healthcare Cost and Utilization Project State Inpatient Database for adult patients with cirrhosis, as defined by International Classification of Diseases, Ninth Revision (ICD-9) codes, hospitalized in California between 2009 and 2011...
February 19, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29431486/reducing-recurrent-hospital-admissions-in-patients-with-decompensated-cirrhosis
#6
Richard J Aspinall
Recurrent admissions to hospital are a major issue for people living with decompensated cirrhosis, particularly those who develop chronic hepatic encephalopathy, a condition that leads to significantly impaired quality of life for patients and their family caregivers. Such patients have high health-care use costs but recent data have shown how the appropriate use of effective medical therapy can significantly reduce hospital admissions, length of stay and unplanned readmissions. Redesigning clinical services to optimize access to specialist care and improving the education and support of patients and their carers can further help to reduce the burden of this disease...
February 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29404526/incidence-and-cost-analysis-of-hospital-admission-and-30-day-readmission-among-patients-with-cirrhosis
#7
Sakkarin Chirapongsathorn, Chayakrit Krittanawong, Felicity T Enders, Richard Pendegraft, Kristin C Mara, Bijan J Borah, Sue L Visscher, Conor G Loftus, Vijay H Shah, Jayant A Talwalkar, Patrick S Kamath
We examined risks for first hospitalization and the rate, risk factors, costs, and 1-year outcome of 30-day readmission among patients admitted for complications of cirrhosis. Data were retrospectively analyzed for adult patients with cirrhosis residing in Minnesota, Iowa, or Wisconsin and admitted from 2010 through 2013 at both campuses of the Mayo Clinic Hospital in Rochester, MN. Readmission was captured at the two hospitals as well as at community hospitals in the tristate area within the Mayo Clinic Health System...
February 2018: Hepatology communications
https://www.readbyqxmd.com/read/29230145/practical-issues-in-the-management-of-overt-hepatic-encephalopathy
#8
Ganesh Pantham, Kevin D Mullen
Hepatic encephalopathy (HE) is a condition that encompasses a range of neuropsychiatric abnormalities in patients with significant liver disease. Overt HE occurs in approximately 30% to 45% of patients with cirrhosis. This article discusses practical issues in the management of patients with overt HE and cirrhosis, including a recently developed 4-pronged approach that consists of identifying and correcting precipitating factors, recognizing and treating concomitant medical conditions, commencing empiric treatment, and caring for the unconscious patient...
November 2017: Gastroenterology & Hepatology
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
#9
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...
February 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28918191/development-and-validation-of-a-chronic-pancreatitis-prognosis-score-in-2-independent-cohorts
#10
Georg Beyer, Ujjwal M Mahajan, Christoph Budde, Thomas J Bulla, Thomas Kohlmann, Louise Kuhlmann, Kerstin Schütte, Ali A Aghdassi, Eckhard Weber, F 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 used to develop a 3-stage chronic pancreatitis prognosis score (COPPS)...
December 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
#11
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...
January 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28858068/inflammatory-bowel-disease-predictors-and-causes-of-early-and-late-hospital-readmissions
#12
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
#13
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
#14
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...
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28820039/sepsis-at-a-safety-net-hospital-risk-factors-associated-with-30-day-readmission
#15
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
#16
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
#17
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
#18
RANDOMIZED CONTROLLED TRIAL
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
#19
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
#20
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
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