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HEPACONTROL. 一种可降低失代偿期肝硬化患者早期再入院率、60 天死亡率和医疗成本的方案。

HEPACONTROL. A program that reduces early readmissions, mortality at 60 days, and healthcare costs in decompensated cirrhosis.

机构信息

University Hospital Germans Trias i Pujol, Liver Unit, Gastroenterology, Barcelona, Spain; Department of Medicine - Autonomous University of Barcelona, Barcelona, Spain.

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.

出版信息

Dig Liver Dis. 2018 Jan;50(1):76-83. doi: 10.1016/j.dld.2017.08.024. Epub 2017 Aug 13.

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.

摘要

背景与目的

失代偿期肝硬化患者的早期再入院率、死亡率和经济负担较高。HEPACONTROL 的目的是降低早期再入院率,并评估其对死亡率和急诊科就诊的影响。

患者和方法

这是一项具有对照组的准实验研究,比较了两组因肝硬化相关并发症入院后出院的患者。前瞻性队列(n=80),遵循 HEPACONTROL 计划,该计划在出院后七天在肝病科日间医院进行随访检查开始,回顾性队列(n=112)的患者接受了标准随访。比较两组之间的观察变量是早期再入院率、出院后急诊科就诊次数、经济成本和死亡率。

结果

HEPACONTROL 组的早期再入院率较低(11.3%比 29.5%;P=.003)。此外,出院后急诊科就诊的平均次数(1.10±1.64 比 1.71±2.36;P=.035)、60 天死亡率(3.8%比 14.3%;P=.016)和早期再入院的成本均低于标准随访组(P=.029)。

结论

HEPACONTROL 可降低失代偿期肝硬化患者的早期再入院率、急诊科就诊率和 60 天死亡率,且具有成本效益。

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