Betty P Morales1, Ramon Planas2, Ramon Bartoli3, Rosa M Morillas4, Margarita Sala4, Irma Casas5, Carolina Armengol3, Helena Masnou6. 1. University Hospital Germans Trias i Pujol, Liver Unit, Gastroenterology, Barcelona, Spain; Department of Medicine - Autonomous University of Barcelona, Barcelona, Spain. Electronic address: betty.pao82@hotmail.com. 2. University Hospital Germans Trias i Pujol, Liver Unit, Gastroenterology, Barcelona, Spain; Department of Medicine - Autonomous University of Barcelona, Barcelona, Spain; Centre for Biomedical Research in Liver and Digestive Diseases, CIBERHED (According to its Initials in Spanish), Barcelona, Spain. 3. Centre for Biomedical Research in Liver and Digestive Diseases, CIBERHED (According to its Initials in Spanish), Barcelona, Spain; The Germans Trias i Pujol Foundation, Gastroenterology, Spain. 4. University Hospital Germans Trias i Pujol, Liver Unit, Gastroenterology, Barcelona, Spain; Centre for Biomedical Research in Liver and Digestive Diseases, CIBERHED (According to its Initials in Spanish), Barcelona, Spain. 5. University Hospital Germans Trias i Pujol, Preventive Medicine and Epidemiology Department, Autonomous University of Barcelona, Barcelona, Spain. 6. University Hospital Germans Trias i Pujol, Liver Unit, Gastroenterology, Barcelona, Spain.
Abstract
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. Outcome variables that were compared between both groups were early readmission rates, the number of emergency department visits post-discharge, financial costs and mortality. RESULTS: The rate of early readmission was lower in the group with HEPACONTROL (11.3% vs 29.5%; P=.003). Also, the mean number of visits to the emergency department post-discharge (1.10±1.64 vs 1.71±2.36; P=.035), mortality at 60days (3.8% vs 14.3%; P=.016), and the cost of early readmission were all lower compared with the group with standard follow-up (P=.029). CONCLUSIONS: HEPACONTROL decreases the incidence of early readmission the rate of emergency department visits and mortality at 60days in patients with decompensated cirrhosis, and it is cost-effective.
BACKGROUND & AIMS: Decompensated cirrhosispatients 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. Outcome variables that were compared between both groups were early readmission rates, the number of emergency department visits post-discharge, financial costs and mortality. RESULTS: The rate of early readmission was lower in the group with HEPACONTROL (11.3% vs 29.5%; P=.003). Also, the mean number of visits to the emergency department post-discharge (1.10±1.64 vs 1.71±2.36; P=.035), mortality at 60days (3.8% vs 14.3%; P=.016), and the cost of early readmission were all lower compared with the group with standard follow-up (P=.029). CONCLUSIONS:HEPACONTROL decreases the incidence of early readmission the rate of emergency department visits and mortality at 60days in patients with decompensated cirrhosis, and it is cost-effective.
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Authors: Roger Williams; Charles Alessi; Graeme Alexander; Michael Allison; Richard Aspinall; Rachel L Batterham; Neeraj Bhala; Natalie Day; Anil Dhawan; Colin Drummond; James Ferguson; Graham Foster; Ian Gilmore; Raphael Goldacre; Harriet Gordon; Clive Henn; Deirdre Kelly; Alastair MacGilchrist; Roger McCorry; Neil McDougall; Zulfiquar Mirza; Kieran Moriarty; Philip Newsome; Richard Pinder; Stephen Roberts; Harry Rutter; Stephen Ryder; Marianne Samyn; Katherine Severi; Nick Sheron; Douglas Thorburn; Julia Verne; John Williams; Andrew Yeoman Journal: Lancet Date: 2021-03-11 Impact factor: 202.731