Evidence map›Paper›PMID 38466464›Full record

ArticleDigestive diseases and sciences2024

Hospital-Level Care at Home for Patients with Cirrhosis.

Olivia Kahn-Boesel, Henry Mitchell, Lucinda Li, Ennie Zhu, Areej El-Jawahri, David Levine, Nneka N Ufere

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Digestive diseases and sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05205954 (HepHospital), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT05205954 narecruitingnot on this mapstarted 2025, after this paper: background citation

HepHospital: A Pilot Trial of a Hepatology Home Hospital Intervention for Patients With Advanced Liver Disease

TypeinterventionalSponsorMassachusetts General HospitalRan2025 to 2026Enrolled30ConditionsCirrhosis, End Stage Liver DIsease, Liver Cirrhosis, Liver Disease ChronicArmsHepatology Home Hospital
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. 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

7 authors.

Olivia Kahn-BoeselHarvard Medical School, Boston, MA, USA.
Henry MitchellDepartment of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Lucinda LiLiver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, MA, USA.
Ennie ZhuLiver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, MA, USA.
Areej El-JawahriMassachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
David Levine *Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Nneka N Ufere *Liver Center, Gastrointestinal Division, Massachusetts General Hospital, Boston, MA, USA. nneka.ufere@mgh.harvard.edu.

Funding

Massachusetts General Hospital Division of Gastroenterology Innovation and Collaboration Award
6 · The paper itself

Abstract

backgroundPatients with cirrhosis have a 30-day readmission rate of over 30%. Novel care delivery models are needed to reduce healthcare costs and utilization associated with cirrhosis care. One such model is Home Hospital (HH), which provides inpatient-level care at home. Limited evidence currently exists supporting HH for cirrhosis patients.

aimsThe aims of this study were to characterize patients with cirrhosis who received hospital-level care at home in a two-site clinical trial and to describe the care they received. Secondary aims included describing their outcomes, including adverse events, readmissions and mortality.

methodsWe identified all patients with cirrhosis who enrolled in HH as part of a two-site clinical trial between 2017 and 2022. HH services include daily clinician visits, intravenous and oral medications, continuous vital sign monitoring, and telehealth specialist consultation. We collected sociodemographic data and analyzed HH stays, including interventions, outcomes, adverse events, and follow-up.

results22 patients with cirrhosis (45% Hispanic; 50% limited English proficiency, median MELD-Na 12) enrolled in HH during the study period. Interventions included lab chemistries (82%), intravenous medications (77%), specialist consultation (23%), and advanced diagnostics/procedures (23%). The median length of stay was 7 days (IQR 4-12); 186 bed-days were saved. Two patients (9%) experienced adverse events (AKI). No patients required escalation of care; 9% were readmitted within 30 days.

conclusionsIn this two-site study, HH was feasible for patients with cirrhosis, holding promise as a hepatology delivery model. Future randomized trials are needed to further evaluate the efficacy of HH for patients with cirrhosis.

Indexed as

Liver CirrhosisAgedFemaleHome Care ServicesHome Care Services, Hospital-BasedHumansMaleMiddle AgedPatient ReadmissionDecompensated cirrhosisHealthcare costsHospital at homeReadmissions

Identifiers

PMID38466464

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Registered trials

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