A Multidisciplinary Team Approach to the Treatment of Liver Cirrhosis

Abstract

Objective To explore the feasibility of treating cirrhosis using a multidisciplinary team approach (MDT) and to pinpoint the key factors influencing its implementation. Methods The data of 307 patients with decompensated cirrhosis were studied retrospectively. Patients who received more than two treatment measures were assigned to the MDT group (n=228), and patients who received symptomatic medical drug treatment only were assigned to the traditional treatment group (n=79). The follow-up period ranged from 4 to 10 years, and the average follow-up period was 5.7 years. The results of the biochemical tests for hepatitis B virus deoxyribonucleic acid, hepatitis C virus ribonucleic acid, and autoantibodies to liver disease were analyzed. Results The differences in gender and Child–Pugh grade of liver function between the two groups were not statistically significant. The MDT group had obvious advantages over the traditional treatment group in occupational composition, etiology composition, 5-year survival rate and annual hospitalization times. The leading causes of death in the MDT group, in descending order, were liver cancer, infection, mesenteric thrombosis, and non-hepatic disease, and, in the medical treatment group, they were liver failure, gastrointestinal bleeding, infection, and liver cancer. There was a significant statistical difference between the two groups (p < 0.05). In the multidisciplinary treatment, etiological treatment was the most widely used treatment, accounting for 79.8%, followed by endoscopic treatment (33.3%), peritoneal drainage and ascites reinfusion (25%), splenectomy combined with devascularization (11.4%) and stem cell transplantation and liver transplantation (1.8%). Conclusion An MDT can improve the efficacy and prognosis of patients with cirrhosis and improve patient compliance. After multi-disciplinary intervention, the mortality spectrum of long-term survival patients with cirrhosis changes, and the mortality rate of liver cancer and non-liver disease increases.

Critical shortfalls in the management of PBC: Results of a UK-wide, population-based evaluation of care delivery

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Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

“…A study by Zhang et al of 307 patients with chronic liver disease patients reported 5-year survival rates to be improved in patients under the care of a multidisciplinary team. 37 A recent study by Singhal et al, using similar dataset from NIS, examined in-hospital mortality of HRS among patients with NASH, alcoholic lever disease (ALD), and chronic viral hepatitis cirrhosis. 9 Their study population had a similar mortality rate as in the current report (25.8%).…”

“…A study by Zhang et al . of 307 patients with chronic liver disease patients reported 5‐year survival rates to be improved in patients under the care of a multidisciplinary team 37 …”

The Evolution in Non-Alcoholic Fatty Liver Disease Patients’ Profile and the Associated Sustainable Challenges: A Multidisciplinary Perspective

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