Efficacy of a Chronic Disease Management Model for Patients With Chronic Liver Failure

Wigg, Alan; McCormick, Rosemary; Wundke, Rachel; Woodman, Richard

doi:10.1016/j.cgh.2013.01.014

Cited by 108 publications

(161 citation statements)

References 29 publications

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“…Although the exact pathophysiology of ACLF development is unclear, unregulated inflammation is considered to be a major contributing factor (2). Furthermore, clinical manifestations are often characterized by severe gastrointestinal tract symptoms, rapidly increased jaundice, massive ascites, hepatic encephalopathy, hepatorenal syndrome (HRS), coagulopathy with severe bleeding tendency and rapidly progressing multi-organ failure, which may require liver transplantation (3).…”

Section: Introductionmentioning

confidence: 99%

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Zhang

Guo

Zhao

et al. 2016

Experimental and Therapeutic Medicine

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Abstract.The present study aimed to analyze the prognostic factors of acute-on-chronic liver failure (ACLF), with the perspective of an improved selection of optimal therapeutic schemes. A retrospective analysis was used to study 164 patients with ACLF hospitalized between 2010 and 2014 in a single center. Patients were divided into favorable and unfavorable groups, according to the treatment outcomes. General characteristics and clinical manifestations were analyzed to determine whether they would affect the prognosis of the patients with ACLF, with a particular focus on the scoring systems Child-Pugh, model for end-stage liver disease (MELD), MELD with incorporation of sodium (MELD-Na), MELD and serum sodium ratio (MESO) and integrated MELD (iMELD). Hepatitis B virus infection was the predominant cause of ACLF, accounting for 88 cases (53.7%). Age, prothrombin time, thrombin time, international normalized ratio (INR), prothrombin activity, serum sodium, albumin, total bilirubin, serum creatinine, platelets, fasting blood sugar, infections, hepatic encephalopathy, hepatorenal syndrome (HRS), and electrolyte disorder were revealed to be associated with prognosis. Age, serum sodium, INR, HRS, and infection were independent prognostic risk factors, as determined by multivariate analysis. Child-Pugh, MELD, MELD-Na, MESO and iMELD scoring systems all demonstrated adequate predictive values, with MELD-Na as the most effective scoring system. In conclusion, age, hyponatremia, INR, HRS and bacterial or fungal infections were reported to be independent prognostic risk factors for ACLF. Among the various liver function scoring systems, MELD-Na was the most accurate in predicting the prognosis of ACLF.

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Section: Introductionmentioning

confidence: 99%

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Zhang

Guo

Zhao

et al. 2016

Experimental and Therapeutic Medicine

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“…Variceal bleeding may cause upper gastrointestinal hemorrhage due to portal hypertension. It remains one of the most important complications of chronic liver disease and one of the largest causes of mortality in this group [2] [37]. These patients have a permanent state of hyperdynamic circulation, with pronounced splanchnic vasodilatation.…”

Section: Discussionmentioning

confidence: 99%

“…In Taiwan, liver cirrhosis and other chronic liver diseases together are the eighth-leading cause of death overall [1]. This patient group also accounts for 75% of unplanned readmissions to the Gastroenterology and Hepatology unit in an Australian hospital [2]. In Brazil, liver cirrhosis was also the eighth-leading cause of death among men and accounted for almost 9% of hospital admissions in 2010 [3]- [6].…”

Section: Introductionmentioning

confidence: 99%

Nursing Diagnosis in Patients with Liver Cirrhosis in Use of Feeding Tube

Gimenes¹,

Silva²,

Lopes³

et al. 2016

OJN

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The objective was to identify the most frequent nursing diagnoses labels in patients with liver cirrhosis in use of feeding tube. A descriptive research was carried out in a Brazilian Hospital with 20 adult patients. Systematic data collection utilized the Conceptual Model of Wanda Horta, the first nurse to introduce the concept of Nursing Process in Brazil. The six phases of the nursing diagnostic reasoning proposed by Risner were used; nursing diagnoses were described according to NANDA-I taxonomy II. Patients were mainly male; half of them were middle age adults; they had an average of 12.8 nursing diagnoses labels; and the most frequent were: risk for aspiration and risk for infection. Nurses needed to develop effective skills to properly diagnose in order to provide safe care and improve patient outcomes.

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“…However, some benefits were observed (eg, significant increases in outpatient attendance), and the authors concluded that larger trials with longer follow-up periods were warranted. 111 Figure 5. Improving the management of cirrhosis: a conceptual model.…”

Section: Hepatic Encephalopathymentioning

confidence: 99%

Understanding the Complexities of Cirrhosis

Muir

2015

Clinical Therapeutics

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Patients at risk for cirrhosis should be screened and the underlying etiologic factor(s) of the liver disease treated or appropriately managed when possible. Primary care physicians should be aware of the signs and symptoms of cirrhosis and its related complications and adopt a low threshold for referral to a specialist when the condition is suspected. An integrated, multidisciplinary approach to care between specialists and primary care physicians may improve early detection of cirrhosis and its related complications and strengthen management strategies.

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Efficacy of a Chronic Disease Management Model for Patients With Chronic Liver Failure

Cited by 108 publications

References 29 publications

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Prognostic performance of clinical indices and model scorings for acute-on-chronic liver failure: A study of 164 patients

Nursing Diagnosis in Patients with Liver Cirrhosis in Use of Feeding Tube

Understanding the Complexities of Cirrhosis

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