VIENNA — In this exclusive video from the International Liver Congress 2019, Elliot B. Tapper, MD, from the University of Michigan, discusses understanding and reducing risks for hospital readmission in patients with compensated cirrhosis and acute-on-chronic liver failure.
According to Tapper, studies have shown that readmission in these diseases occurs at a rate between approximately 25% and 30% within 30 days, which he said prompts the question: “How are we going to go about safely reducing that awful statistic?”
“I like to focus on what I think is the gold standard in this field, which is not only understanding reasons for readmission — namely, hepatic encephalopathy, substance abuse, and complications of medical care like the troubles you can run into with patients on diuretics — but understanding how to identify that, like calling a patient after discharge, making sure that they have their labs checked in a timely fashion,” Tapper told Healio Gastroenterology and Liver Disease.
These factors must supplant simply referring a patient to the emergency department or the “path of least resistance.”
An example he gave of resource management to reduce readmissions was “care management checkup” programs in Europe in which patients with cirrhosis can visit “day hospitals” and be evaluated by experts who are comfortable managing patients in the outpatient setting.
“Understanding the outpatient resources that are necessary to supplant the emergency room and rehospitalization is absolutely critical to reducing readmissions,” Tapper concluded.
Reference: Tapper EB. Prevention of hospitalizations and early re-admissions in decompensated cirrhosis. Presented at: International Liver Congress; April 10-14, 2019; Vienna, Austria.
Disclosure: Tapper reports unrestricted grants from Gilead and Valeant; and consults for Novartis and Salix.