Better adherence to components of an acute care bundle improves 90‐day mortality from acute decompensated chronic liver disease: a retrospective study.
Aim: To evaluate whether adherence to an acute care bundle (ACB) for decompensated cirrhosis is associated with improved patient outcomes, including 90‐day mortality, in an Australian tertiary hospital setting. Methods: This retrospective cohort study included all patients admitted with decompensate...
| Publicado en: | Internal Medicine Journal Vol. 55; no. 12; pp. 2033 - 2042 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192281229&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192281229 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14440903 HYC jtl: Internal Medicine Journal issn: 14440903 maglogo: Y pubinfo: dt: Dec2025 vid: 55 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 192281229 188973196 192281229 192281229 10.1111/imj.70244 192281229 ppf: 2033 ppct: 9 formats: tig: atl: Better adherence to components of an acute care bundle improves 90‐day mortality from acute decompensated chronic liver disease: a retrospective study. aug: au: Huang, Andrea Palmer, Andrew Valery, Patricia C. Mickenbecker, Matthew Johnston, Alex O'Sullivan, Timothy Chen, Hayley Woodward, Aidan Haque, Mazhar Clark, Paul J. affil: Department of Gastroenterology & Hepatology, Mater Hospital, Brisbane Queensland, Australia sug: subj: Liver Cirrhosis Therapy Acute Care Patient Compliance Outcomes (Health Care) Liver Cirrhosis Prognosis Tertiary Health Care Australia Human Retrospective Design Descriptive Statistics Data Analysis Software Australia Prospective Studies Electronic Health Records Male Female Middle Age Aged Multivariate Analysis Logistic Regression Odds Ratio Confidence Intervals Kaplan-Meier Estimator Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Aim: To evaluate whether adherence to an acute care bundle (ACB) for decompensated cirrhosis is associated with improved patient outcomes, including 90‐day mortality, in an Australian tertiary hospital setting. Methods: This retrospective cohort study included all patients admitted with decompensated cirrhosis between June 2016 and March 2018 at a tertiary metropolitan teaching hospital. ACB adherence was assessed among six domains during the first 24 h of admission. Outcomes included in‐hospital, 30‐ and 90‐day mortality, hospital readmission and long‐term survival. Results: A total of 157 admissions from 85 patients were included. Median follow‐up was 7 years, during which the overall mortality rate reached 74%. Short‐term (30‐day) mortality was not significantly associated with ACB adherence. However, 90‐day mortality was significantly lower in patients with ≥70% adherence (13.8% vs 25.4%, P < 0.05) and ≥80% adherence (9.7% vs 25.9%, P < 0.01), independent of Model for End‐Stage Liver Disease (MELD) score, Child‐Pugh class or admitting team. No significant differences were observed in readmission rates or long‐term survival. Conclusion: Greater adherence to ACB components in the first 24 h of admission was associated with improved 90‐day mortality in patients with decompensated cirrhosis, regardless of disease severity or admitting service. These findings support the use of the ACB as a pragmatic quality improvement tool. Prospective validation is warranted. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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