Evidence map›Paper›PMID 34144013›Full record

ArticleThe American journal of medicine2021

Impact of Inpatient Attending Specialty and Gastroenterology Consultation on Quality of Care of Patients Hospitalized with Decompensated Cirrhosis.

Juan J Gonzalez, Jacob DiBattista, Victoria Gomez, Emelie Gonzalez, Qisu Zhang, Valerie M Vaughn, Elliot B Tapper

Open access · greenAbstract read
In one paragraph

Article in The American journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.5field-weighted citation impact, top 38% of its field
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

5 citing papers in PubMed, 6 citations in OpenAlex.

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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

7 authors at 3 institutions in 2 countries.

Juan J GonzalezDivision of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor. Electronic address: juanjgon@umich.edu.
Jacob DiBattistaDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor.
Victoria GomezUniversity of Michigan Medical School, Ann Arbor.
Emelie GonzalezFacultad de Medicina Dr. Jose Edmundo Vasquez, Universidad Dr. Jose Matias Delgado, La Libertad, El Salvador.
Qisu ZhangDivision of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
Valerie M VaughnDivision of General Internal Medicine, Department of Internal Medicine, University of Utah Medical School, Salt Lake City.
Elliot B TapperDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
University of Michigan · USJose Matias Delgado University · SVUniversity of Utah · US

Funding

Optimizing Measures for Clinical Trials in Covert Hepatic EncephalopathyK23DK117055 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI TAPPER, ELLIOT · 2019 to 2022
$776k
NIDDK NIH HHS K23 DK117055
6 · The paper itself

Abstract

backgroundData suggest hospitalists are less adherent to quality indicators for decompensated cirrhosis, and gastroenterology consultation may improve adherence. We sought to evaluate the impact of inpatient attending specialty and gastroenterology consultation on quality of care for decompensated cirrhosis.

methodsThis was a retrospective cohort study of patients with decompensated cirrhosis admitted to gastroenterology or hospitalist service at the University of Michigan between 2016-2020. The primary outcome was adherence to nationally recommended inpatient quality indicators for ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, and gastrointestinal bleeding. Performance was calculated per patient admission as the proportion of quality indicators met vs quality indicators for which the patient was eligible. Quality indicator scores were compared between services using t-tests. We also evaluated the effect of gastroenterology consultation on quality indicator scores for patients admitted to hospitalist service. Clinical outcomes were compared using multivariable models adjusted for patient characteristics.

resultsTwo hundred eighty-eight admissions were included (155 to gastroenterology service; 133 to hospitalist service). Quality indicator score for all admissions was 69.9% (standard deviation [SD] ± 24.2%). Quality indicator scores were similar between gastroenterology (69.9%, SD ± 23.6%) and hospitalist (69.8%, SD ± 25.1%) services (P = .913). There was no difference in quality indicator subscores for each complication between services. Hospitalists placed a gastroenterology consultation in 53.4% of admissions, and it was associated with higher albumin administration for patients with spontaneous bacterial peritonitis (57.1% vs 25%, P = .044). Patients admitted to gastroenterology service had higher readmissions within 30 days (adjusted odds ratio = 1.95) and shorter length of hospitalization (adjusted rate ratio = 0.85).

conclusionsHospitalists provided comparable quality of care to gastroenterologists for inpatients with decompensated cirrhosis.

Indexed as

GastroenterologyHospitalistsMedicineQuality Indicators, Health CareReferral and ConsultationAgedFemaleHospitalizationHumansLiver CirrhosisMaleMichiganMiddle AgedPatient AdmissionRetrospective StudiesDecompensated cirrhosisGastroenterologyHealthcare qualityHospitalist

Identifiers

PMID34144013
PMCPMC10838397
OpenAlexW3169571052

What OpenQuestion holds

Textmetadata
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Read underepoch 390

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.