التفاصيل البيبلوغرافية
| العنوان: |
Regional variations in inpatient decompensated cirrhosis mortality may be associated with access to specialist care: results from a multicentre retrospective study |
| المؤلفون: |
The Trainee Collaborative for Research and Audit in Hepatology UK, Tavabie, Oliver D, Kronsten, Victoria T, Li, Wenhao, Abeysekera, Kushala WM, Brennan, Paul N, Marjot, Thomas, Nayagam, Jeremy S, Dhaliwal, Amritpal, Hardy, Tim, Maurice, James B, Zakeri, Nekisa, Abbas, Nadir, Abbasi, Abdullah, Abbott, Jane, Abdul, Rahman, Abdulaziz, Mohamed, Abduljabbar, Duaa, Adamson, Robbie, Adebayo, Danielle, Adhikarla, Aditya Kumar, Adler, Maciej, Afifi, Mostafa, Ahmad, Salman, Ahmed, Shayan, Aithal, Guruprasad, Akram, Ali, Al Radhi, Balqees, Al-Talib, Ismaeel, Alele, Jolomi, Ali, Alaa Mohammed, Almusai, Safa, Appleby, Victoria, Asmat, Huma, Astbury, Sarah, Atkinson, Ali, Badrulhisham, Fakhirah, Balachandrakumar, Vinay K, Ball, Alexandra, Banfa, Moses, Barn, Jeevan, Begum, Shahnaz, Belfield, Katherine, Bendall, Oliver, Bennett, Kris, Bernal, William, Bhandari, Rajan, Bhatti, Prashan, Bradley, Meg, Brown, Edward, Bryce, Kathleen, Buchanan, Ryan, Burke, Laura, Campbell, Roisin, Cargill, Tamsin, Carroll, Geraldine, Cartledge, James, Chatterjee, Devnandan, Chaundry, Rayan, Choudhry, Zeshan, Clare, Kathleen, Cobbold, Jeremy, Coburn, Robert, Cook, Charlotte, Corvan, Fintan, Cox, Rebecca, Craig, Darren, Creamer, John, Curran, Christopher, De Silva, Shanika, Dean, Laurence, Dillon, Jayne, Dillon, John, Dunn, Rebecca, Eckersley, Robert, Eike, Gidveig, Elagib, Amul, Elkholi, Ayman, Elshaarawy, Omar, Faloon, Sarah, Fan, Francis, Fazili, Mohammad, Fernandes, Denzil, Fox, James, Foxton, Matthew, Gaba, Waqas, Gaikwad, Girish, Gairola, Abishek, Galanakis, Vasileios, Gallaher, Charles, Gautam, Nisham, Germain, Lewis, Giles, Ben, Gill, Ceri, Glover, Ben, Glover, John, Gomez, David, Gomez, Michael, Gordon, Victoria, Gormley, Sarah, Goulder, John, Goyal, Simran, Greenham, Olivia, Guthrie, Sarah, Hackett, Richard, Haddadin, Yazan, Hadjinicolaou, Andreas, Hall, Jonathan, Hamza, Mohammed, Haque, Tasnuma, Harris, Rebecca, Hart, Catherine, Hasan, Sundas, Hasnain Nadir, Syed Mujtaba, Hassall, James, Hawker-Bond, George, Hawkyard, Jake, Healey, Scott, Hogan, Brian, Hornby, Catherine, Humayun, MD, Hutchison, John, Iftikhar, Zahra, Ismail, Asem, James, Joel, Jones, Rebecca, Jopson, Laura, Juthani, Dipal, Kaina, Philippa, Karim, Aadil, Karim, Syed Misbah, Kashyap, Vaishnavi, Kassab, Mohamed, Katarey, Dev, Kenny, Lee, Kerry, Georgina, Khan, Adnan, Khan, Ayesha, Khan, Azab, Khan, Muhammad Taha, Khan, Tahir, Khatib, Aseil, Khattak, Mohammad Fawad, King, Ji Jade, Kooner, Emily, Korani, Mohammed, Kotha, Sreelakshmi, Lam, Wai Liam, Lateef, Mohammed, Leighton, Jess, Leith, Damien, Liaros, Angela, Liu Yin, James, Lourenco, Floyd, Lyles, Annabel, Macken, Lucia, Magee, Ciaran, Maggs, Daniel, Mahalingam, Aarani, Mahenthiran, Midusa, Mahmood, Rizwan, Mandour, Mandour Omer, Manocha, Namita, Mansour, Dina, Marks, Daniella, Martin, Ciara, Martin, Harry, Martin, Iana, Martin, Katherine, Maruthan, Sachan, Masin, Rhys, Mason, Denise, Matthews, Charmaine, Mavrou, Athina, Maxan, Ema, Maxfield, Dominic, McAvoy, Emma, McCaughan, Hannah, McColl, Kirsty, McCorry, Roger, McDonald, Stewart, McDowell, Hannah, McGoran, John, McIlwane, Stewart, McPherson, Stuart, Meakin, Olivia, Mebarek, Leila, Merrill, Hannah, Michail, Stephanie, Modarres, Pedram, Mohamedali, Alaa, Mohammed, Yaser, Mohammed, Zakiuddin, Mohan, Jaiganesh, Monnier, Chloe, Moran, Eilis, Moroni, Francesca, Morrison, Gary, Msaddi, Anas, Mutar, Sarah, Nahed, Ismail, Navaratnam, Janardhan, Neto-Pereira, Luis, Ng, Jennifer, Nwoguh, Chinonso, O’Kane, Rebecca, Omar, Sohail, Ososanya, Abosede, Parambil, Jessiya Veliyankodan, Patel, Jay, Pericleous, Marinos, Pervais, Zeshan, Phoolchund, Anju, Pietrzycki, Julian, Pillay, Lushen, Pohl, Keith, Prabhu, Kiran, F Putri, Yesita Rizky, Qazi, Umang, Rafique, Khizar Khalid, Raghuraman, Arun, Raman, Krithivasan, Ranade, Vaishali, Rastelli, Francesca, Ratcliffe, Elizabeth, Rattehalli, Deepa, Raza, Tufail, Razak, Amir, Read, George, Robins, Anne, Rowe, Ian, Rushbrook, Simon, Salama, Mohamed, Saravan, Ramasamy, Sarkar, Srishti, Saunsbury, Emma, Scott, Jennifer, Serna, Solange, Shahzad, Hassnain, Shamsaldeen, Mohammed, Sharip, Mohammed, Shearer, Jessica, Sheikh, Adam, Sheiybani, Giovanna, Sherwin, Michelle, Sheth, Abhishek, Shintre, Nidhi, Singhal, Saket, Sinha, Rohit, Sinharay, Ricky, Smith, Gloria, Smith, Ria, Snowdon, Victoria, Spicer, Joanne, Spoor, Johannes, Sreenivasan, Shiva, Srinivasa, Amar, Srivastava, Ankur, St Aimee, Louise, Stagg, Georgia, Stanley, Jatinder, Stevenson, Jason, Stokes, Daniel, Stroud, Robert, Subhani, Mohsan, Suliman, Hiba, Sultana, Marium, Summers, Nikki, Sutherland, Chloe, Swann, Rachael, Sykes, Lynne, Taha, Mostafa, Tan, Kwei Eng, Tariq, Zohaib, Ming Tay, Joshua Jun, Taylor, Alison, Thakor, Amit, Tsang, James, Turner, Lucy, Tyler, Zaccharie, Unitt, Esther, Volcek, Edward, Watson, Iona, Watters, Chris, Wells, Gemma, White, Helen, Widlak, Monika, Williams, Matthew, Wischhusen, Jack, Woodland, Hazel, Wren, Louise, Xyda, Souzana, Yeh, Julian, Young, Alison, Yuan, Jack Shie Jie |
| بيانات النشر: |
BMJ Publishing Group Ltd |
| سنة النشر: |
2024 |
| المجموعة: |
HighWire Press (Stanford University) |
| مصطلحات موضوعية: |
Liver |
| الوصف: |
Introduction Specialist centres have been developed to deliver high-quality Hepatology care. However, there is geographical inequity in accessing these centres in the United Kingdom (UK). We aimed to assess the impact of these centres on decompensated cirrhosis patient outcomes and understand which patients transfer to specialist centres. Methods A UK multicentred retrospective observational study was performed including emergency admissions for patients with decompensated cirrhosis in November 2019. Admissions were grouped by specialist/non-specialist centre designation, National Health Service region and whether a transfer to a more specialist centre occurred or not. Univariable and multivariable comparisons were made. Results 1224 admissions (1168 patients) from 104 acute hospitals were included in this analysis. Patients at specialist centres were more likely to be managed by a Consultant Gastroenterologist/Hepatologist on a Gastroenterology/Hepatology ward. Only 24 patients were transferred to a more specialist centre. These patients were more likely to be admitted for gastrointestinal bleeding and were not using alcohol. Specialist centres eliminated regional variations in mortality which were present at non-specialist centres. Low specialist Consultant staffing numbers impacted mortality at non-specialist centres (aOR 2.15 (95% CI 1.18 to 4.07)) but not at specialist centres. Hospitals within areas of high prevalence of deprivation were more likely to have lower specialist Consultant staffing numbers. Conclusions Specialist Hepatology centres improve patient care and standardise outcomes for patients with decompensated cirrhosis. There is a need to support service development and care delivery at non-specialist centres. Formal referral pathways are required to ensure all patients receive access to specialist interventions. |
| نوع الوثيقة: |
text |
| وصف الملف: |
text/html |
| اللغة: |
English |
| العلاقة: |
http://fg.bmj.com/cgi/content/short/15/1/3Test; http://dx.doi.org/10.1136/flgastro-2023-102412Test |
| DOI: |
10.1136/flgastro-2023-102412 |
| الإتاحة: |
https://doi.org/10.1136/flgastro-2023-102412Test
http://fg.bmj.com/cgi/content/short/15/1/3Test |
| حقوق: |
Copyright (C) 2024, BMJ Publishing Group Ltd |
| رقم الانضمام: |
edsbas.800EED4C |
| قاعدة البيانات: |
BASE |
