Objectives: To compare the incidence of liver‐related emergency admissions and survival of patients after hospitalisation for decompensated cirrhosis at two major hospitals, one applying a coordinated chronic disease management model (U1), the other standard care (U2); to examine predictors of mortality for these patients. Design: Retrospective observational cohort study. Setting: Two major tertiary hospitals in an Australian capital city. Participants: Patients admitted with a diagnosis of decompensated cirrhosis during October 2013 – October 2014, identified on the basis of International Classification of Diseases (ICD‐10) codes. Main outcome measures: Incident rates of liver‐related emergency admissions; survival (to 3 years). Results: Sixty‐nine patients from U1 and 54 from U2 were eligible for inclusion; the median follow‐up time was 530 days (range, 21–1105 days). The incidence of liver‐related emergency admissions was lower for U1 (mean, 1.14 admissions per person‐year; 95% CI, 0.95–1.36) than for U2 (mean, 1.55 admissions per person‐year; 95% CI, 1.28–1.85; adjusted incidence rate ratio [U1 v U2], 0.52; 95% CI, 0.28–0.98; P = 0.042). The adjusted probabilities of transplantation‐free survival at 3 years were 67.7% (U1) and 37.2% (U2) (P = 0.009). Independent predictors of reduced transplantation‐free free survival were Charlson comorbidity index score (per point: hazard ratio [HR], 1.27; 95% CI, 1.05–1.54, P = 0.014), liver‐related emergency admissions within 90 days of discharge (HR, 3.60; 95% CI, 1.87–6.92; P < 0.001), and unit (U2 v U1: HR, 2.54, 95% CI, 1.26–5.09; P = 0.009). Conclusions: A coordinated care model for managing patients with decompensated cirrhosis was associated with improved survival and fewer liver‐related emergency admissions than standard care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.