Evidence map›Paper›PMID 34374917›Full record

ArticleDigestive diseases and sciences2022

Inpatient Gastroenterology Consultation and Outcomes of Cirrhosis-Related Hospitalizations in Two Large National Cohorts.

Marina Serper, David E Kaplan, Menghan Lin, Tamar H Taddei, Neehar D Parikh, Rachel M Werner, Elliot B Tapper

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Digestive diseases and sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.2field-weighted citation impact, top 20% 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

8 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Marina SerperDivision of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, 3400 Spruce St, 2 Dulles, Philadelphia, PA, USA. Marinas2@pennmediicne.upenn.edu.ORCID 0000-0003-4899-2160
David E KaplanDivision of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, 3400 Spruce St, 2 Dulles, Philadelphia, PA, USA.
Menghan LinDivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, USA.
Tamar H TaddeiVA Connecticut Healthcare System, West Haven, CT, USA.
Neehar D ParikhDivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, USA.
Rachel M WernerCorporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
Elliot B TapperDivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, USA.
Philadelphia VA Medical Center · USUniversity of Michigan · USYale University · US

Funding

Developing technology-based approaches to improve access and quality of care in cirrhosisK23DK115897 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI SERPER, MARINA · 2018 to 2022
$961k
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 DK115897NIDDK NIH HHS K23 DK117055
6 · The paper itself

Abstract

backgroundLittle is known about use of specialty care among patients admitted with cirrhosis complications.

aimsWe sought to characterize the use and impact of gastroenterology/hepatology (GI/HEP) consultations in hospitalized patients with cirrhosis. We studied two national cohorts-the Veterans Affairs Costs and Outcomes in Liver Disease (VOCAL) and a nationally representative database of commercially insured patients (Optum Clinformatics™ DataMart).

methodsCirrhosis-related admissions were classified by ICD9/10 codes for ascites, hepatic encephalopathy, alcohol-associated hepatitis, spontaneous bacterial peritonitis, or infection related. We included 20,287/222,166 index admissions from VOCAL/Optum from 2010 to 2016. Propensity-matched analyses were conducted to balance clinical characteristics. Mortality and readmission were evaluated using competing risk regression (subhazard ratios, sHR), and length of stay (LOS) was assessed using negative binomial regression.

resultsGI/HEP consultations were completed among 37% and 42% patients in VOCAL and Optum, respectively. In propensity-matched analyses for VOCAL, GI/HEP consultation was associated with adjusted estimates of increased LOS (1.55 + 1.03 additional days), 90-day mortality (sHR 1.23, 95% CI 1.14-1.36), and lower 30-day readmissions (sHR 0.82, 95% CI 0.75-0.89). In Optum, inpatient consultation was associated with higher LOS (1.13 + 1.01 additional days), higher 90-day mortality (sHR 1.57, 95% CI 1.43-1.72), and higher 30-day readmission risk (sHR 1.04, 95% CI 1.02-1.05). Post-discharge primary and specialty care was higher among admissions receiving GI/HEP consultation in both cohorts.

conclusionsUse of GI/HEP consultation for cirrhosis-related admissions was low. Patients who received consultation had higher disease severity, and consultation was not associated with lower mortality but was associated with lower 30-day readmissions in the VA cohort only.

Indexed as

GastroenterologyAftercareHospitalizationHumansInpatientsLength of StayLiver CirrhosisPatient DischargePatient ReadmissionReferral and ConsultationRetrospective StudiesAccess to careAlcoholAscitesHepatic encephalopathyLiver diseaseQuality

Identifiers

PMID34374917
PMCPMC10849043
OpenAlexW3187713535

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.