S1250 A Pilot Study to Improve Resident Paracentesis Training and Reduce Paracentesis Delay in Admitted Patients With Cirrhosis

Abstract

We aimed to assess statin utilization as a function of calculated ASCVD risk score in HCV-infected individuals to further understand the implications of the inaccuracies with the Pooled Cohort Equation in estimating CVD risk in this population. Methods: We performed a single-center retrospective study of HCV-infected individuals aged 40-75 years. The 10-year ASCVD risk score was calculated for each subject using the 2013 American College of Cardiology/American Heart Association Pooled Cohort Equation. Statin use was determined by review of prescribed medications from 2019-2021. Results: A total of 1,077 subjects were included in analysis. The proportions of subjects being treated with a statin were calculated for ASCVD risk groups of , 5%, 5-7.4%, 7.5-9.9%, 10-19.9% and $ 20%. Statins were prescribed in 19/237 (8.0%), 18/131 (13.7%), 23/98 (23.5%), 112/361 (31.0%), and 134/250 (53.6%) respectively. For individuals with a 10-year risk $ 7.5%, a total of 269/709 (37.9%) were treated with a statin. Conclusion: Our results indicate that while statin utilization appropriately increases among HCV-infected individuals as 10-year ASCVD risk score increases, statins remain underutilized even in very high-risk individuals. With recent literature suggesting that the Pooled Cohort Equation underestimates CVD risk in HCV-infected individuals with a risk $ 7.5%, the importance of increasing efforts to increase statin use for primary CVD prevention in these patients is clear. Considerable retrospective data and limited prospective data are available that support the safety of statins in chronic liver disease, including compensated cirrhosis. Further prospective study to assure the safety and efficacy of statins in preventing CVD in HCV-infected population is warranted. (Table ) Chew KW, Bhattacharya D, Horwich TB, Yan P, McGinnis KA, Tseng C, et al. Performance of the Pooled Cohort atherosclerotic cardiovascular disease risk score in hepatitis C virus-infected persons.

The Impact of a Paracentesis Clinic on Internal Medicine Resident Procedural Competency

“…Pham and colleagues showed that integrating paracentesis into timely training can reduce paracentesis delay and delays in care. 7 By increasing the volume of procedures each resident performs and creating a sense of confidence amongst residents, the clinic increases the number of residents able and willing to perform inpatient procedures, thus reducing the number of unnecessary consultations and hospital resources. One of the reasons the paracentesis clinic was started was to allow patients to have scheduled times to remove fluid from their abdomen, thus cutting down on emergency depart-ment procedures and unnecessary admissions.…”