The impact of a care pathway with systematical screening for cardiopulmonary complications, frailty, malnutrition and minimal hepatic encephalopathy in cirrhosis on patient care and hospital financing
| Journal | Volume 89 - 2026 |
| Issue | Fasc.1 - Original articles |
| Author(s) | D. Coevoet 1 2, J. Schouten 1 2, C. Fierens 3, W. Verlinden 1 4 |
| Full article |
 PAGES 3-11 VIEW FREE PDF |
| DOI | 10.51821/89.1.14452 |
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Affiliations: (1) Department of Gastroenterology & Hepatology, VITAZ, Sint-Niklaas, Belgium
(2) Department of Gastroenterology & Hepatology, Uz Gent, Ghent, Belgium (3) Department of medical registration, VITAZ, Sint-Niklaas, Belgium (4) Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Belgium |
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Background and aim of the study: Cardiopulmonary complications, malnutrition, frailty and minimal hepatic encephalopathy are underrecognized complications of cirrhosis with a major impact on mortality and morbidity. The aim of this study is to investigate a new locally introduced care pathway with standardized screening for these complications and its impact on patients care and hospital financing. Patients and methods: We performed a single center retrospective study of 40 patients hospitalized with cirrhosis who participated in the care pathway between April 2023 and June 2024. Electronic medical records were evaluated for screened complications and financial outcomes were calculated within our population, consecutively with and without this care pathway. Long term data regarding survival and referral were collected in June 2025. Results: Hepatopulmonary syndrome was diagnosed in 14.7% of the patients. Frailty was present in 57.7% of the patients and malnutrition in 45%. Minimal hepatic encephalopathy was established in 17.5% of the patients. The median justified hospital days were significantly higher with the care pathway compared to without [8.4 (6.0-10.8) vs 6.2( 4.9-8.6) p<0.01 ( Z=-3.43)]. In 15 (37.5%) patients, the care pathway added a higher financial reimbursement for the hospital compared to when the care pathway would not have been performed. Conclusions: This study emphasizes the importance of systematic screening and education of these complications. Due to systematical screening these underrecognized complications get identified earlier. Performing this care pathway did significantly and positively impact the number of justified hospital days and financial reimbursement for the hospital. Keywords: hepatopulmonary syndrome, cirrhotic cardiomyo-pathy, portopulmonary syndrome, justified hospital days, DRG. |
| The authors declare that they have no conflict of interest. |
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© Acta Gastro-Enterologica Belgica. PMID 41745633 |