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Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h

Recently, there has been a significant increase in the prevalence of chronic liver disease in the UK, and as a result, hospital admissions and deaths due to liver disease have also increased. The 2013 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) of patients with alcohol-rela...

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Autores principales: McPherson, Stuart, Dyson, Jessica, Austin, Andrew, Hudson, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717433/
https://www.ncbi.nlm.nih.gov/pubmed/26834955
http://dx.doi.org/10.1136/flgastro-2014-100491
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author McPherson, Stuart
Dyson, Jessica
Austin, Andrew
Hudson, Mark
author_facet McPherson, Stuart
Dyson, Jessica
Austin, Andrew
Hudson, Mark
author_sort McPherson, Stuart
collection PubMed
description Recently, there has been a significant increase in the prevalence of chronic liver disease in the UK, and as a result, hospital admissions and deaths due to liver disease have also increased. The 2013 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) of patients with alcohol-related liver disease (ARLD) found that less than half the number of patients who died from ARLD received ‘good care’, and avoidable deaths were identified. In order to improve the care of patients admitted with ARLD, the NCEPOD report recommended that a ‘toolkit’ for the acute management of patients admitted with decompensated ARLD be developed and made widely available. As a result, we have developed a ‘care bundle’ for patients admitted with decompensated cirrhosis (of all aetiologies) to ensure that effective evidence-based treatments are delivered within the first 24 h. This care bundle provides a checklist to ensure that all appropriate investigations are undertaken when a patient with decompensated cirrhosis presents and provides clinicians with clear guidance on the initial management of alcohol withdrawal, infection, acute kidney injury, gastrointestinal bleeding and encephalopathy. The first 24 h are particularly important, as early intervention can reduce mortality and shorten hospital stay, and specialist gastroenterology/liver advice is not always available during this period. This review will discuss the care bundle and the evidence base behind the treatment recommendations made.
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spelling pubmed-47174332016-01-28 Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h McPherson, Stuart Dyson, Jessica Austin, Andrew Hudson, Mark Frontline Gastroenterol Liver Recently, there has been a significant increase in the prevalence of chronic liver disease in the UK, and as a result, hospital admissions and deaths due to liver disease have also increased. The 2013 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) of patients with alcohol-related liver disease (ARLD) found that less than half the number of patients who died from ARLD received ‘good care’, and avoidable deaths were identified. In order to improve the care of patients admitted with ARLD, the NCEPOD report recommended that a ‘toolkit’ for the acute management of patients admitted with decompensated ARLD be developed and made widely available. As a result, we have developed a ‘care bundle’ for patients admitted with decompensated cirrhosis (of all aetiologies) to ensure that effective evidence-based treatments are delivered within the first 24 h. This care bundle provides a checklist to ensure that all appropriate investigations are undertaken when a patient with decompensated cirrhosis presents and provides clinicians with clear guidance on the initial management of alcohol withdrawal, infection, acute kidney injury, gastrointestinal bleeding and encephalopathy. The first 24 h are particularly important, as early intervention can reduce mortality and shorten hospital stay, and specialist gastroenterology/liver advice is not always available during this period. This review will discuss the care bundle and the evidence base behind the treatment recommendations made. BMJ Publishing Group 2016-01 2014-12-02 /pmc/articles/PMC4717433/ /pubmed/26834955 http://dx.doi.org/10.1136/flgastro-2014-100491 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Liver
McPherson, Stuart
Dyson, Jessica
Austin, Andrew
Hudson, Mark
Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
title Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
title_full Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
title_fullStr Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
title_full_unstemmed Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
title_short Response to the NCEPOD report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
title_sort response to the ncepod report: development of a care bundle for patients admitted with decompensated cirrhosis—the first 24 h
topic Liver
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717433/
https://www.ncbi.nlm.nih.gov/pubmed/26834955
http://dx.doi.org/10.1136/flgastro-2014-100491
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