ArticleHepatology (Baltimore, Md.)2019
Quality Measures, All-Cause Mortality, and Health Care Use in a National Cohort of Veterans With Cirrhosis.
Article in Hepatology (Baltimore, Md.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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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.
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Who cites it
25 citing papers in PubMed, 48 citations in OpenAlex.
- Randomized intervention and outpatient follow-up lowers 30-d readmissions for patients with hepatic encephalopathy, decompensated cirrhosis.World journal of hepatology · 2023Trial
- Barriers to Medical Care Are Frequently Reported by Patients With Cirrhosis.Alimentary pharmacology & therapeutics · 2026Article
- Clinical outcomes and care for spontaneous bacterial peritonitis: A national cohort study.Hepatology (Baltimore, Md.) · 2025Article
- Albumin for Spontaneous Bacterial Peritonitis: Care Variation, Disparities, and Outcomes.The American journal of gastroenterology · 2024Article
- Organizational and Implementation Factors Associated with Cirrhosis Care in the Veterans Health Administration.Digestive diseases and sciences · 2024Article
- Changes in the etiology of liver cirrhosis and the corresponding management strategies.World journal of hepatology · 2024Article
- Undiagnosed Cirrhosis and Hepatic Encephalopathy in a National Cohort of Veterans With Dementia.JAMA network open · 2024Article
- Associations of Race and Ethnicity with Hepatocellular Carcinoma, Decompensation, and Mortality in US Veterans with Cirrhosis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023Article
- MELD-Lactate Predicts Poor Outcome in Variceal Bleeding in Cirrhosis.Digestive diseases and sciences · 2023Article
- Rising incidence, progression and changing patterns of liver disease in Wales 1999-2019.World journal of hepatology · 2023Article
- Inpatient Gastroenterology Consultation and Outcomes of Cirrhosis-Related Hospitalizations in Two Large National Cohorts.Digestive diseases and sciences · 2022Article
- The answer at our fingertips: Volume status in cirrhosis determined by machine learning and pulse oximeter waveform.Physiological reports · 2022Article
- The Future of Quality Improvement for Cirrhosis.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2021Review
- Mortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation.Hepatology (Baltimore, Md.) · 2021Article
- Moving Toward Impact: An Introduction to Implementation Science for Gastroenterologists and Hepatologists.Gastroenterology · 2020Article
- Getting to implementation: a protocol for a Hybrid III stepped wedge cluster randomized evaluation of using data-driven implementation strategies to improve cirrhosis care for Veterans.Implementation science : IS · 2020Article
- Telemedicine in Liver Disease and Beyond: Can the COVID-19 Crisis Lead to Action?Hepatology (Baltimore, Md.) · 2020Article
- The COVID-19 pandemic will have a long-lasting impact on the quality of cirrhosis care.Journal of hepatology · 2020Review
- Improved survival after treatments of patients with nonalcoholic fatty liver disease associated hepatocellular carcinoma.Scientific reports · 2020Article
- Non-invasive diagnosis of variceal bleeding: choose the right target population and identify the right culprit.Annals of translational medicine · 2020Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
Decompensated cirrhosis is associated with high morbidity and mortality. However, no standardized quality measures (QMs) have yet been adopted widely. The Veterans Affairs (VA) Advanced Liver Disease Technical Advisory Group recently developed a set of six internal QMs to guide quality improvement efforts in cirrhosis in the domains of access to care, hepatocellular carcinoma surveillance, variceal surveillance, quality of inpatient care for upper gastrointestinal bleeding, and cirrhosis-related rehospitalizations. We aimed to (1) quantify adherence to cirrhosis QMs and (2) determine whether adherence was associated with all-cause mortality and health care use within a large national cohort of veterans with cirrhosis. We performed a retrospective study using data from the Veterans Outcomes and Costs Asociated with Liver Disease cohort of 121,129 patients newly diagnosed with cirrhosis from January 1, 2008, to December 31, 2016, at 128 VA facilities. The mean follow-up time was 2.7 years (interquartile range, 1.1-5.1 years). Adherence to outpatient access to specialty care was 71%, variceal surveillance was 32%, and early postdischarge care was 54%. In adjusted analyses, outpatient access to specialty care (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.78-0.82), hepatocellular carcinoma surveillance (HR, 0.92; 95% CI, 0.90-0.95), variceal surveillance (HR, 0.93; 95% CI, 0.89-0.99), and early postdischarge care (HR, 0.57; 95% CI, 0.54-0.60) were associated with lower all-cause mortality. Readmissions after 30 days (HR, 1.53; 1.46-1.60) and 90 days (HR, 1.88; 95% CI, 1.54-1.70) were associated with higher all-cause mortality. Higher adherence to QMs was also associated with lower inpatient health care use. Conclusion: Five of the six proposed VA cirrhosis QMs were measurable using existing data sources, associated with mortality and health care use, and may be used to guide future quality improvement efforts in cirrhosis.
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