ArticleAlimentary pharmacology & therapeutics2016
Implementation of a 'care bundle' improves the management of patients admitted to hospital with decompensated cirrhosis.
Article in Alimentary pharmacology & therapeutics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 41 citations in OpenAlex.
- Management of acute decompensated cirrhosis.Clinical medicine (London, England) · 2025Review
- Increased 30-day mortality associated with weekend emergency admission for alcohol-related liver disease in England: a record-linkage study using the Clinical Practice Research Datalink.BMJ open gastroenterology · 2025Article
- Effect of PI3K/AKT/mTOR signaling pathway-based clustered nursing care combined with papaverine injection on vascular inflammation and vascular crisis after replantation of severed fingers.Molecular and cellular biochemistry · 2024Article
- Regional variations in inpatient decompensated cirrhosis mortality may be associated with access to specialist care: results from a multicentre retrospective study.Frontline gastroenterology · 2024Article
- National study of NAFLD management identifies variation in delivery of care in the UK between 2019 to 2022.JHEP reports : innovation in hepatology · 2023Article
- Observational
- Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group.BMJ open gastroenterology · 2023Article
- Admission care bundles for decompensated cirrhosis are poorly utilised across the UK: results from a multi-centre retrospective study.Clinical medicine (London, England) · 2023Observational
- Improved outcomes following the implementation of a decompensated cirrhosis discharge bundle.Frontline gastroenterology · 2022Article
- Implementation of a care bundle improves the management of patients with non-alcoholic fatty liver disease.Frontline gastroenterology · 2021Article
- When a new definition overhauls perceptions of MAFLD related cirrhosis care.Hepatobiliary surgery and nutrition · 2020Article
- Increased cardiovascular risk and reduced quality of life are highly prevalent among individuals with hepatitis C.BMJ open gastroenterology · 2020Observational
- Cost-effectiveness of integrating gut microbiota analysis into hospitalisation prediction in cirrhosis.GastroHep · 2020Article
- British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding.Frontline gastroenterology · 2020Article
- Management of decompensated cirrhosis.Clinical medicine (London, England) · 2018Review
- Review
- Improving Quality of Care in Patients with Liver Cirrhosis.Middle East journal of digestive diseases · 2017Review
- Corrigendum.Alimentary pharmacology & therapeutics · 2017Article
Corrections and comments
- Commented on by
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- Erratum issuedCorrigendum.2017
Authors and funding
14 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince 1970, there has been a 400% increase in liver-related deaths due to the increasing prevalence of chronic liver disease in the United Kingdom (UK). The 2013 UK National Confidential Enquiry into Patient Outcome and Death report found that only 47% of patients who died from alcohol-related liver disease received 'good care' during their hospital stay.
aimTo develop a 'care bundle' for patients with decompensated cirrhosis, aiming to ensure that evidence-based treatments are delivered within the first 24 h of hospital admission.
methodsThis work gives practical advice about how to implement the bundle and examines its effects on patient care at three National Health Service Hospital Trusts in the UK by collecting data on patient care before and after introduction of the bundle.
resultsData were collected on 228 patients across three centres (59% male, median age 53 years). Alcohol-related liver disease was the aetiology of chronic liver disease in 85% of patients. The overall mortality rate during hospital admission was 15%. The audits demonstrated improvements in patient care for patients with a completed care bundle who were significantly more likely to have a diagnostic ascitic performed within the first 24 h (P = 0.020), have an accurate alcohol history documented (P < 0.0001) and be given antibiotics as prophylaxis against infection following a variceal haemorrhage (P = 0.0096). In Newcastle, the bundle completion rate increased from 25% to 90% during the review periods.
conclusionsThe introduction of a care bundle was associated with increased rates of diagnostic paracentesis and antibiotic prophylaxis with variceal haemorrhage in patients with decompensated cirrhosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.