Evidence map›Paper›PMID 34655539›Full record

ArticleThe American journal of medicine2022

Attendance at a Transitional Liver Clinic May Be Associated with Reduced Readmissions for Patients with Liver Disease.

Lindsay Yoder, Andrea Mladenovic, Francis Pike, Raj Vuppalanchi, Haleigh Hanson, Laura Corbito, Archita P Desai, Naga Chalasani, Eric S Orman

Open access · greenAbstract read
In one paragraph

Article in The American journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 26% 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

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Measuring Medication Use, Obstacles, and Knowledge in Individuals With Cirrhosis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023
    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 at 2 institutions in 1 country.

Lindsay YoderDivision of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis; Digestive & Liver Disorders, Indiana University Health, Indianapolis.
Andrea MladenovicDivision of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis.
Francis PikeDepartment of Biostatistics, Indiana University School of Medicine, Indianapolis.
Raj VuppalanchiDivision of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis; Digestive & Liver Disorders, Indiana University Health, Indianapolis.
Haleigh HansonDigestive & Liver Disorders, Indiana University Health, Indianapolis.
Laura CorbitoDigestive & Liver Disorders, Indiana University Health, Indianapolis.
Archita P DesaiDivision of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis; Digestive & Liver Disorders, Indiana University Health, Indianapolis.
Naga ChalasaniDivision of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis; Digestive & Liver Disorders, Indiana University Health, Indianapolis.
Eric S OrmanDivision of Gastroenterology & Hepatology, Indiana University School of Medicine, Indianapolis; Digestive & Liver Disorders, Indiana University Health, Indianapolis. Electronic address: esorman@iu.edu.
Indiana University Health · USIndiana University School of Medicine

Funding

The Intersection of Personalized Medicine and Implementation Science to Improve Healthcare Utilization in CirrhosisK23DK123408 · NIDDK · INDIANA UNIVERSITY INDIANAPOLIS · PI DESAI, ARCHITA P. · 2020 to 2024
$903k
Unplanned Early Readmissions of Hospitalized Patients with CirrhosisK23DK109202 · NIDDK · INDIANA UNIVERSITY INDIANAPOLIS · PI ORMAN, ERIC · 2016 to 2021
$811k
NIDDK NIH HHS K23 DK109202NIDDK NIH HHS K23 DK123408
6 · The paper itself

Abstract

introductionPatients with liver disease have high rates of early hospital readmission, but there are no studies of effective, scalable interventions to reduce this risk. In this study, we examined the impact of a Physician Assistant (PA)-led post-discharge Transitional Liver Clinic (TLC) on hospital readmissions.

methodsWe performed a cohort study of all adults seen by a hepatologist during admission to a tertiary care center in 2019 (excluding transplant patients). We compared those who attended the TLC with those who did not, with respect to 30-day readmission and mortality. Propensity score-adjusted modeling was used to control for confounding.

resultsOf 498 patients, 98 were seen in the TLC; 35% had alcoholic liver disease and 58% had cirrhosis. Attendees were similar to non-attendees with respect to demographics, liver disease characteristics and severity, comorbidities, and discharge disposition. Thirty-day cumulative incidence of readmissions was 12% in TLC attendees, compared with 22% in non-attendees (P = .02), while 30-day mortality was similar (2.0% vs 4.3%; P = .29). In a model using propensity score adjustment, TLC attendance remained associated with reduced readmissions (subhazard ratio 0.52; 95% confidence interval, 0.27-0.997; P = .049). The effect of TLC was greater in women compared with men (P = .07) and in those without chronic kidney disease (P = .02), but there were no differences across other subgroups.

conclusionsPatients with liver disease seen in a PA-led TLC may have a significant reduction in the 30-day readmission rate. Randomized trials are needed to establish the efficacy of PA-led post-discharge transitional care for this population.

Indexed as

Ambulatory CareLiver CirrhosisLiver Diseases, AlcoholicPatient ReadmissionAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedHealth servicesHepatologyHospitalizationTransitional care

Identifiers

PMID34655539
PMCPMC8840978
OpenAlexW3207863448

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.