Abstract
Hepatitis C Follow-Up After Hospital Discharge
The American journal of gastroenterology, v 113(Supplement), S1579
01 Oct 2018
Abstract
Introduction: A sustained virologic response against hepatitis C virus (HCV) is now viable with development of direct-acting antiviral regimens. Although social factors, co-morbidities and insurance may determine if a patient is treated against HCV, it is imperative to follow-up with gastroenterology (GI) for management strategies. We aimed to determine if patients with chronic hepatitis C established care with GI after hospital discharge. Methods: Retrospective chart review of 62 patients with confirmed or reported history of chronic hepatitis C was performed. Confirmation was established with detection of HCV RNA. Patients admitted for both GI-related conditions as well as non GI-associated complaints were included. Presence of cirrhosis, portosystemic encephalopathy (PSE), esophageal varices (EV) and ascites was evaluated. Follow-up with GI after discharge was the primary outcome. Secondary outcomes included 30-days re-admissions, mortality, and GI evaluation during their inpatient stay. Results: Of the 62 patients, 46 (74.2%) were males. 49 (79.0%) patients were confirmed to have HCV but the rest only reported a prior history of chronic hepatitis C. Median age was 54 years and average length of stay was 8.3 days. 9 (14.5%) patients were readmitted to the hospital within 30 days. 22 (35.5%) reported concurrent alcohol use and 24 (38.7%) admitted illicit drug use. Cirrhosis was present in 22 (35.5%), PSE in 12 (19.3%), EV in 10 (16.1%) and ascites in 12 (19.3%) patients. 41 (66.1%) were admitted for non-GI related complaints. At discharge, 35 (56.4%) were referred to GI but only 16 (25.8%) followed with GI as outpatient. Of those that did see GI after discharge, 13 (81.2%) were within first three months of discharge. 9 (14.5%) patients died either during hospitalization or after discharge. Conclusion: Most patients with reported history of hepatitis C did not have cirrhosis and their inpatient admissions were not related to GI problems. Consequently, most of these patients did not see GI as an outpatient. With the change in insurance approval trends for treatment of chronic hepatitis C, this population in initial stages or without cirrhosis would benefit from earlier evaluation by GI to facilitate management before the onset of cirrhosis and its associated complication. Future avenues include introducing prompts in the electronic health record system at the time of discharge to refer patients to GI as well as contacting patients within 30 days of discharge to remind of outpatient visits.
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Details
- Title
- Hepatitis C Follow-Up After Hospital Discharge
- Creators
- Hamza Arif - Allegheny Health NetworkNabeeha Mohy-ud-din - Allegheny Health NetworkArchana Kulkarni - Allegheny Health NetworkMoeezullah Beg - Allegheny Health NetworkSohaib Zahid - Allegheny Health NetworkMichael Babich - Allegheny Health NetworkAnastasios Kapetanos - Allegheny General Hospital
- Publication Details
- The American journal of gastroenterology, v 113(Supplement), S1579
- Publisher
- Wolters Kluwer
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Gastroenterology and Hepatology; General Internal Medicine
- Other Identifier
- 991022076701304721