• 作者：Marta Gallach^a ; ^{martagm81@hotmail.com} ; Judit Pé ; rez^b ; Mercedes Vergara^a ; ^d ; Gemma Olivé ; ^c ; Mireia Miquel^a ; ^d ; Meritxell Casas^a ; Montserrat Gil^a ; Blai Dalmau^a ; ^d ; Jordi S&#225 ; nchez^a ; ^d ; Angelina Dosal^a ; Laura Moreno^a ; Eulà ; lia Alavedra^a ; Emili Gené ; ^c ; ^d
• 关键词：Cirrosis hepá ; tica ; Servicios mé ; dicos de emergencias ; Atenció ; n ambulatoria
• 刊名：Gastroenterolog铆a y Hepatolog铆a
• 出版年：2011
• 期刊代码：pca167_02105705
• 类别：med
• 出版时间：November 2011
• 卷：34
• 期：9
• 页码：599-604
• 文件大小：123 K

lass="h4">Introduction

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.

lass="h4">Methods and material

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.

lass="h4">Results

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).

lass="h4">Conclusion

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.