A dedicated paracentesis clinic decreases healthcare utilization for serial paracenteses in decompensated cirrhosis

Purpose The purpose of the study is to describe the effect of a dedicated paracentesis clinic on healthcare utilization by patients with decompensated cirrhosis and refractory ascites. Methods This Institutional Review Board-approved retrospective study identified cirrhotic patients receiving parace...

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Bibliographic Details
Published in:Abdominal imaging 2018-08, Vol.43 (8), p.2190-2197
Main Authors: Cheng, Yao-Wen, Sandrasegaran, Kumar, Cheng, Katherine, Shah, Angela, Ghabril, Marwan, Berry, William, Lammert, Craig, Chalasani, Naga, Orman, Eric S.
Format: Article
Language:English
Subjects:
Ascites
Cirrhosis
Complications
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Etiology
Female
Follow-Up Studies
Gastroenterology
Health care
Health services utilization
Hepatology
Hospitalization - statistics & numerical data
Humans
Identification methods
Imaging
Kidneys
Liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Outpatients - statistics & numerical data
Paracentesis - methods
Paracentesis - statistics & numerical data
Patients
Radiology
Retrospective Studies
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Summary:Purpose The purpose of the study is to describe the effect of a dedicated paracentesis clinic on healthcare utilization by patients with decompensated cirrhosis and refractory ascites. Methods This Institutional Review Board-approved retrospective study identified cirrhotic patients receiving paracenteses over a 6-month period before and after creating the paracentesis clinic. Patients were followed for 12 months to collect outcome data including characteristics of subsequent hospitalizations and paracenteses. Logistic regression was used to examine the association between the paracentesis clinic and outcomes. Results There were 183 patients and 1364 paracenteses performed during the study time period. Age, gender, cirrhosis etiology, MELD, Child–Pugh, and Charlson comorbidity index were comparable between the two groups. Rates of mortality, transplant, and hospitalization were also similar during 1 year follow-up. After establishment of the paracentesis clinic, median paracenteses per patient increased from 2 (IQR 1–7) to 4 (IQR 2–11) ( P  = 0.01); albumin replacement after paracenteses ≥ 5 L improved from 76.3% to 91.7% ( P  
ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-017-1406-y