Underutilization of Hospice in Inpatients with Cirrhosis: The NACSELD Experience

Digestive Diseases and Sciences
Jacqueline G O'LearyJasmohan S Bajaj

Abstract

Little is known about patients discharged to hospice following hospitalization for complications of cirrhosis. We sought to understand the current pattern of hospice utilization in patients with cirrhosis by evaluating the North American Consortium for the Study of End-stage Liver Disease (NACSELD) cohort. Patients with cirrhosis from 14 tertiary-care hepatology centers across North America non-electively hospitalized and prospectively enrolled were evaluated. Exclusion criteria included HIV infection, transplantation or non-hepatic malignancy. Random computer-based propensity score matching was undertaken in a 1:2 ratio based on admission MELD score ± 3 points. Totally, 2718 patients were enrolled, 5% (N = 132) were discharged to hospice, 6% (N = 171) died, and the rest were discharged alive. Patients discharged to hospice were older (60 vs. 57 years, p = 0.04), less likely to have had SBP (13% vs. 28%, p = 0.002) and be listed for liver transplantation (11% vs. 26%, p = 0.0007). Features, on multivariable modeling, associated with increased probability of discharge to hospice as opposed to being discharged alive: grade-3-4 hepatic encephalopathy, a higher Child-Turcotte-Pugh (CTP) score, and a higher discharge serum creatinin...Continue Reading

References

May 16, 2006·Gastroenterology·Scott W BigginsGoran Klintmalm
Sep 5, 2008·The New England Journal of Medicine·W Ray KimTerry M Therneau
Jul 19, 2012·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jasmohan S BajajUNKNOWN NACSELD
May 4, 2013·Alimentary Pharmacology & Therapeutics·J H Lewis, J G Stine
Jun 14, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Shari S RogalEva Szigethy
Sep 4, 2013·Gastroenterology·Florence WongUNKNOWN North American Consortium for Study of End-Stage Liver Disease
Mar 29, 2014·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jasmohan S BajajUNKNOWN North American Consortium For The Study Of End-Stage Liver Disease (NACSELD)
Aug 19, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jacqueline G O'LearyUNKNOWN North American Consortium for the Study of End-Stage Liver Disease
Dec 9, 2014·Journal of Hepatology·Florence WongUNKNOWN North American Consortium for the Study of End-Stage Liver Disease
Apr 8, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·K Rajender ReddyUNKNOWN North American Consortium for the Study of End-Stage Liver Disease
Dec 23, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jasmohan S BajajUNKNOWN North American Consortium for the Study of End-Stage Liver Disease
Jun 7, 2016·Journal of Pain and Symptom Management·Cristal L BrownAndrew J Muir
Aug 26, 2016·Clinical and Translational Gastroenterology·Dae J KangJasmohan S Bajaj
Sep 30, 2016·World Journal of Transplantation·Priya KathpaliaJennifer C Lai
Oct 21, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Alina M AllenPatrick S Kamath
Oct 11, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Patricia HuelinPere Ginès
Oct 11, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Jasmohan S BajajK Rajender Reddy
Feb 10, 2017·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Arpan A PatelNeil Wenger
Mar 21, 2017·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Fu-Ming ChangChing-Liang Lu
Apr 26, 2017·The American Journal of Gastroenterology·F WongJ S Bajaj
Aug 13, 2017·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Chris EstesArun J Sanyal
Nov 11, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Andrew S AllegrettiRavi I Thadhani
Jan 10, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jacqueline G O'LearyJasmohan S Bajaj
Mar 25, 2018·Current Treatment Options in Gastroenterology·Carlos Moctezuma-VelázquezAldo J Montano-Loza
Jan 30, 2019·The American Journal of Gastroenterology·Jasmohan S BajajK Rajender Reddy
Feb 7, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jacqueline G O'LearyK Rajender Reddy
Feb 14, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Zachary P Fricker, Marina Serper
Jun 11, 2019·The American Journal of Gastroenterology·Jasmohan S BajajK Rajender Reddy

❮ Previous
Next ❯

Citations

Nov 23, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Alyson KaplanRussell Rosenblatt

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

CA: a Cancer Journal for Clinicians
B E Robinson
The Weather Vane
S O'Neil
Nursing Homes
M D Norgard
Journal - American Health Care Association
W Healy
A Report of the ... National Forum on Hospital and Health Affairs
J Mahoney
© 2021 Meta ULC. All rights reserved