Social Support Does Not Modify the Risk of Readmission for Patients with Decompensated Cirrhosis

Louissaint, Jeremy; Foster, C Jonathan; Harding-Theobald, Emily; Lok, Anna S.; Tapper, Elliot B.

doi:10.1007/s10620-020-06421-0

Cited by 3 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The etiology of cirrhosis in India was mainly hepatitis B virus (50.4%), while in North America and Europe, the main causes of cirrhosis were alcohol consumption (29.4%) and HCV (39.3%) (10,11). We identified bacterial infection as the main reason for index admission and readmission (54.3% at initial admission, 44.7% at 30 days, 48.2% at 60 days, and 48.9% at 90 days), distinct from findings from India, North America, and Europe, where hepatic encephalopathy and ascites were identified as the main contributory factors (10,11,16,18,36). This difference may be associated with the distinct inclusion/exclusion criteria and medical conditions in different regions.…”

Section: Discussionmentioning

confidence: 88%

“…INR and TB are critical markers of liver protein synthesis function and the extent of hepatocellular necrosis (23,43). These three indicators are all or partly involved in the construction of CLIF-C ADs, MELD-Nas, MELDs, and CTPs, reported to be significantly associated with the prognosis of AD cirrhosis or readmission (6,11,16,18,31,36). However, owing to the involvement of the logarithm in calculations of MELDs, MELD-Nas, and CLIF-C ADs, clinicians have to use calculators, making it impractical in busy clinical practice.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Stratification Score to Predict Readmission of Patients With Acute Decompensated Cirrhosis Within 90 Days

Tan

Wang

et al. 2021

Front. Med.

View full text Add to dashboard Cite

Background and Aims: Patients with acute decompensated (AD) cirrhosis are frequently readmitted to the hospital. An accurate predictive model for identifying high-risk patients may facilitate the development of effective interventions to reduce readmission rates.Methods: This cohort study of patients with AD cirrhosis was conducted at six tertiary hospitals in China between September 2012 and December 2016 (with 705 patients in the derivation cohort) and between January 2017 and April 2020 (with 251 patients in the temporal validation cohort). Least absolute shrinkage and selection operator Cox regression was used to identify the prognostic factors and construct a nomogram. The discriminative ability, calibration, and clinical net benefit were evaluated based on the C-index, area under the curve, calibration curve, and decision curve analysis. Kaplan–Meier curves were constructed for stratified risk groups, and log-rank tests were used to determine significant differences between the curves.Results: Among 956 patients, readmission rates were 24.58, 42.99, and 51.78%, at 30, 60, and 90 days, respectively. Bacterial infection was the main reason for index hospitalization and readmission. Independent factors in the nomogram included gastrointestinal bleeding [hazard rate (HR): 2.787; 95% confidence interval (CI): 2.221–3.499], serum sodium (HR: 0.955; 95% CI: 0.933–0.978), total bilirubin (HR: 1.004; 95% CI: 1.003–1.005), and international normalized ratio (HR: 1.398; 95% CI: 1.126–1.734). For the convenience of clinicians, we provided a web-based calculator tool (https://cqykdx1111.shinyapps.io/dynnomapp/). The nomogram exhibited good discrimination ability, both in the derivation and validation cohorts. The predicted and observed readmission probabilities were calibrated with reliable agreement. The nomogram demonstrated superior net benefits over other score models. The high-risk group (nomogram score >56.8) was significantly likely to have higher rates of readmission than the low-risk group (nomogram score ≤ 56.8; p < 0.0001).Conclusions: The nomogram is useful for assessing the probability of short-term readmission in patients with AD cirrhosis and to guide clinicians to develop individualized treatments based on risk stratification.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Risk Stratification Score to Predict Readmission of Patients With Acute Decompensated Cirrhosis Within 90 Days

Tan

Wang

et al. 2021

Front. Med.

View full text Add to dashboard Cite

show abstract

“…A study from North America analyzing the relationship of SS with the rate of hospital readmission due to decompensation has been recently published. 31 The authors did not find statistically significant differences in readmission depending on SS and they did not analyze the effect of SS on mortality. Their results showed that the only factor related with it was the liver function (measured by MELD-Na).…”

Section: Discussionmentioning

confidence: 94%

“…Thus, we conclude that our sample is representative of decompensated LC patients that need admission worldwide. 29 In the recently published study 31 that analyzed the relationship of SS with the rate of readmission in hospital, the results could not demonstrate a statistically significant association between them. lt is important to underline that their cohort of patients was different to ours with regard to the etiol-ogy of LC, as during the time our investigation took place (2016-2019) in the majority of European countries, the most common cause of LC still remained alcohol or viral hepatitis, fallowed by NASH.…”

Section: Discussionmentioning

confidence: 96%

Inadequate social support decreases survival in decompensated liver cirrhosis patients

Morales

Varga

Pérez

et al. 2023

Gastroenterología y Hepatología (English Edition)

View full text Add to dashboard Cite

“…Understanding the type of social support needed by the patient after discharge is essential. Researchers that reported findings from a study related to social support and patients with decompensated cirrhosis noted that further studies need to evaluate specific components of social support that have the potential to reduce the readmissions risk (Louissaint et al, 2020). Based on this scoping review, patients are more likely to need instrumental support as opposed to emotional support, for example.…”

Section: Discussionmentioning

confidence: 99%

Scoping review: Social support impacts hospital readmission rates

Schultz

Corbett

Hughes

et al. 2021

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives: To review and synthesise the current literature on social support and hospital readmission rates.Background: Hospital readmission rates have not declined significantly since 2010 despite efforts to identify and implement strategies to reduce readmissions. After discharge, patients often report the need for help at home with personal care, medical care and/or transportation. Social factors can positively or negatively affect the transition from hospital to home and the extended recovery period experienced by patients.Methods: Published primary studies in peer-reviewed journals, written in English, assessing the adult medical/surgical population and discussing social support and hospital readmission rates were included. A Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was completed for this scoping review. Results:The search resulted in 2919 articles. After removing duplicates and reviewing content for the inclusion and exclusion criteria, 23 articles were selected for review.Social support is provided by those within one's social circle. There are several types of social support and depending on the needs to the patient, the type of social required and provided is different. Conclusions:The most common form of social support needed at home for people recovering after a hospitalisation was instrumental support, tangible care in the form of assistance with daily personal and medical care, and transportation. Patients who lacked adequate social support after discharge were at an increased risk of hospital readmission.Relevance to clinical practice: Identifying factors, such as social support, that may impact hospital readmission rates is important for quality hospital to home care transitions. Assessing patients' needs and available social support to meet those needs may be an essential part of the discharge planning process to decrease the risk of hospital readmission.

show abstract

Social Support Does Not Modify the Risk of Readmission for Patients with Decompensated Cirrhosis

Cited by 3 publications

References 19 publications

Risk Stratification Score to Predict Readmission of Patients With Acute Decompensated Cirrhosis Within 90 Days

Risk Stratification Score to Predict Readmission of Patients With Acute Decompensated Cirrhosis Within 90 Days

Inadequate social support decreases survival in decompensated liver cirrhosis patients

Scoping review: Social support impacts hospital readmission rates

Contact Info

Product

Resources

About