Evidence map›Paper›PMID 30409463›Full record

ArticleThe American journal of emergency medicine2019

Advanced liver fibrosis and care continuum in emergency department patients with chronic hepatitis C.

Yu-Hsiang Hsieh, Danielle Signer, Anuj V Patel, Valentina Viertel, Mustapha Saheed, Risha Irvin, Mark S Sulkowski, David L Thomas, Richard E Rothman

Abstract read
In one paragraph

Article in The American journal of emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Preferences of Persons With or at Risk for Hepatitis C for Long-Acting Treatments.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yu-Hsiang HsiehDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: yhsieh1@jhmi.edu.
Danielle SignerDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Anuj V PatelDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Valentina ViertelDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Mustapha SaheedDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Risha IrvinDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Mark S SulkowskiDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
David L ThomasDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Richard E RothmanDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Funding

Management/Hepatitis C/HIV-infected and Uninfected IDU'sR01DA016065 · NIDA · JOHNS HOPKINS UNIVERSITY · PI SULKOWSKI, MARK SEBASTIAN · 2003 to 2018
$8.0M
HIV HCV Coinfection Antiviral Therapy and FibrosisR37DA013806 · NIDA · JOHNS HOPKINS UNIVERSITY · PI THOMAS, DAVID L · 2010 to 2019
$7.0M
Patient Oriented Research in Hepatitis C-infected Injection Drug UsersK24DA034621 · NIDA · JOHNS HOPKINS UNIVERSITY · PI SULKOWSKI, MARK SEBASTIAN · 2012 to 2022
$1.2M
Cost-Effectiveness of ED HIV Testing Program Agent-Based Modeling ApproachK01AI100681 · NIAID · JOHNS HOPKINS UNIVERSITY · PI HSIEH, YU-HSIANG · 2012 to 2015
$532k
NIAID NIH HHS K01 AI100681NIDA NIH HHS K24 DA034621NIDA NIH HHS R01 DA016065NIDA NIH HHS R37 DA013806
6 · The paper itself

Abstract

backgroundFIB-4, a non-invasive serum fibrosis index (which includes age, ALT, AST, and platelet count), is frequently available during ED visits. Our objective was to define 1-year HCV-related care outcomes of ED patients with known HCV, for the overall group, and both those with and without advanced fibrosis.

methodsAs part of an ongoing HCV linkage-to-care (LTC) program, HCV-infected ED patients were identified retrospectively via medical record review. Components of FIB-4 were abstracted, and patients with an FIB-4 > 3.25 were classified with advanced fibrosis and characterized with regards to downstream HCV care continuum outcomes at one-year after enrollment.

resultsOf the 113 patients with known HCV, 38 (33.6%) had advanced fibrosis. One-year outcomes along the HCV care continuum after ED encounter for 'all' 113, 75 'without advanced fibrosis', and 38 'advanced fibrosis' patients, respectively, were as follows: agreeing to be linked to care [106 (93.8%), 72 (96.0%), 34 (89.5%)]; LTC [38 (33.6%), 21 (28.0%), 17 (44.7%)]; treatment initiation among those linked [16 (42.1%), 9 (42.9%), 7 (41.2%)]; sustained virologic response 4 weeks post-treatment among those treated [15 (93.8%), 9 (100.0%), 6 (85.7%)]; documented all-cause mortality [10 (8.8%), 3 (4.0%), 7 (18.4%)]. Notably, 70% of those who died had advanced fibrosis. For those with advanced liver fibrosis, all-cause mortality was significantly higher, than those without (18.4% versus 4.0%, p = 0.030).

conclusionsOver one-third of HCV-infected ED patients have advanced liver fibrosis, incomplete LTC, and higher mortality, suggesting this readily-available FIB-4 might be used to prioritize LTC services for those with advanced fibrosis.

Indexed as

Continuity of Patient CareEmergency Service, HospitalAdolescentAdultAgedAlanine TransaminaseAspartate AminotransferasesBiomarkersEmergency Medical ServicesFemaleHepatitis C, ChronicHumansLiver CirrhosisMaleMiddle AgedPlatelet CountAlanine TransaminaseAspartate AminotransferasesBiomarkersRNA, ViralCDC recommendationsEmergency departmentHCVHCV testingUndiagnosed infection

Identifiers

PMID30409463
PMCPMC6348121

What OpenQuestion holds

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Registered trials

None linked

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.