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Randomized intervention and outpatient follow-up lowers 30-d readmissions for patients with hepatic encephalopathy,decompensated cirrhosis

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World Journal of Hepatology 2023年第6期15卷 826-840页

作者： Antoinette Pusateri Kevin Litzenberg Claire Griffiths Caitlin Hayes Bipul Gnyawali Michelle Manious Sean G Kelly Lanla F Conteh Sajid Jalil haikady n nagaraja Khalid Mumtaz Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of Internal Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States The Ohio State University College of Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of Gastroenterology and Hepatology The Ohio State Wexner Medical CenterColumbusOH 43210United States Division of Biostatistics The Ohio State UniversityColumbusOH 43210United States

BACKGROUnD We previously reported national 30-d readmission rates of 27% in patients with decompensated cirrhosis(DC).AIM To study prospective interventions to reduce early readmissions in DC at our tertiary *** Adults with DC admitted July 2019 to December 2020 were enrolled and randomized into the intervention(InT) or standard of care(SOC) arms. Weekly phone calls for a month were completed. In the InT arm, case managers ensured outpatient follow-up, paracentesis, and medication compliance. Thirty-day readmission rates and reasons were *** Calculated sample size was not achieved due to coronavirus disease 2019;240 patients were randomized into InT and SOC arms. 30-d readmission rate was 33.75%, 35.83% in the InT vs 31.67% in the SOC arm(P = 0.59). The top reason for 30-d readmission was hepatic encephalopathy(HE, 32.10%). There was a lower rate of 30-d readmissions for HE in the InT(21%) vs SOC arm(45%, P = 0.03). There were fewer 30-d readmissions in patients who attended early outpatient follow-up(n = 17, 23.61% vs n = 55, 76.39%, P = 0.04).COnCLUSIOn Our 30-d readmission rate was higher than the national rate but reduced by interventions in patients with DC with HE and early outpatient follow-up. Development of interventions to reduce early readmission in patients with DC is needed.

关键词： Decompensated cirrhosis Hospital readmissions Interventions

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Gene Copy number variation and associated polymorphisms of complement component C4 in human SLE

Gene Copy number variation and associated polymorphisms of c...

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The 8th International Congress on SLE

作者： Erwin K Chung Yee Ling Wu Stephanie Savelli haikady n nagaraja Maddie Hebert Karla Jones Kathryn Kitzmiller Carol A Blanchong natalieJacobsen-Longman Kim McBride Gloria C Higgins Robert M Rennebohm Robert R Rice Kevin V Hackshaw Robert A Roubey Jennifer M Grossman Betty P Tsao Daniel J Birmingham Brad H Rovin Lee A Hebert C Yung Yu Columbus Children’s Research Institute College of Medicine and Public HealthThe Ohio State UniversityColumbusOhioUSA Division of Rheumatology Allergy and ImmunologyThe University of North Carolina at Chapel HillChapel Hill.NC.USA Department of Internal Medicine University of California.Los AngelesCaliforniaUSA

＜正＞Purpose:To determine the inter-individual gene copy number variation（GCnV）of complement C4 and its associated polymorphisms in gene size（long and short）and protein isotypes（C4A and C4B）in human SLE. Method...

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