The Lancet Gastroenterology & Hepatology
First published: 14 November 2017
Dr Benjamin Hudson, Jeff Round, PhD, Brendan Georgeson, MSc, Andrew Pring, MSc, Prof Karen Forbes, MBChB, Catherine Anne McCune, MD, Prof Julia Verne, PhD
Objective: Liver disease mortality increased by 400% in the UK between 1970 and 2010, resulting in rising pressures on acute hospital services, and an increasing need for end-of-life care. We aimed to assess the effect of demographic, clinical, and health-care factors on costs, patterns of health-care use, and place of death in a national cohort of patients with cirrhosis and ascites in their last year of life.
Methods: We did a retrospective, nationwide analysis of all patients who died from cirrhosis in England between 2013 and 2015, who required large-volume paracentesis in their last year of life. The outcomes measured were health-care costs accrued in the last year of life, number of inpatient days in last year of life, 30-day readmission rate, and occurrence of unplanned hospital death (probability of dying in hospital after unplanned admission).