摘要
Introduction
<p>Because of the current overload of emergency services, new units, such as day units, have had to be created. Liver cirrhosis (LC) is a chronic disease with frequent decompensations requiring medical attention. The aim of this study was to compare differences between emergency consultations in a hepatology day hospital (HDH) and in an emergency service (ES) among patients with LC.Methods and material
<p>We performed an observational prospective study. All patients with LC attending the HDH or ES from September 2007 to August 2008 were asked to complete a questionnaire. Demographic, clinical, and radiological variables were collected.Results
<p>There were 743 consultations, of which 62%involved the HDH. The mean age was 65 卤 12 years, and the male/female ratio was 2:3. The most frequent diagnosis in the ES was hepatic encephalopathy (26.2%ES versus 6%HDH, p < 0.001) followed by upper gastrointestinal hemorrhage (17.7%ES versus 0.6%HDH, p < 0.001), while the most frequent diagnosis in the HDH was ascites (66.2%HDH versus 22.7%ES, p < 0.001). The tests performed were as follows: blood analysis: 95%ES versus 60%HDH (p < 0.01); radiology: 71%ES versus 11%HDH (p < 0.01) and paracentesis: 51%ES versus 74%HDH (p < 0.01). The mean length of stay in the ES was 21.3 卤 121.5 hours compared with 3.3 卤 2.4 hours in the HDH (p < 0.001). A total of 53%of patients attended in the ES were hospitalized compared with 12%of those attended in the HDH (p < 0.05).Conclusion
<p>Patients with LC preferentially attend the HDH, where fewer tests are performed and the length of stay is shorter. The care provided in the HDH is appropriate and efficient.