Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments

Chen-Ju Chuang; Yi-Fang Wu; Kai-Hsiang Wu; Yi-Chuan Chen

doi:10.1155/2020/8289275

Patients with Liver Cirrhosis as Frequent Attenders of Emergency Departments

Emerg Med Int. 2020 Feb 11:2020:8289275. doi: 10.1155/2020/8289275. eCollection 2020.

Authors

Chen-Ju Chuang¹, Yi-Fang Wu¹, Kai-Hsiang Wu¹, Yi-Chuan Chen^{1

2}

Affiliations

¹ Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, No. 6, W. Sec., Jiapu Rd., Puzih City, Chiayi County 613, Taiwan.
² Chang Gung University College of Medicine, No. 5, Fusing St., Gueishan Township, Taoyuan County 333, Taiwan.

Abstract

Objectives: Frequent attendance for nonemergency problems to emergency departments (EDs) contributes to ED overcrowding, resulting in medical care delays, increased medical errors, and social and economic burdens. Most studies regarding frequent attenders of EDs examine general patients without classifying certain subgroups. This study aimed to investigate patients with liver cirrhosis who present repeatedly to the ED.

Methods: This was a retrospective, observational cohort study of adult patients with a history of liver cirrhosis presenting to the ED from January 2011 to December 2015. We included patients with cirrhosis whose first ED visit occurred during the study period. We went far back for 20 years and excluded patients with any ED visits (including both cirrhosis and noncirrhosis-related ones) before the study period. We categorized frequent attenders as patients with more than 4 ED visits within 12 months after the first ED visit; infrequent attenders were those who did not meet this criterion.

Results: A total of 3513 patients with cirrhosis were included in this retrospective cohort study. Compared with the infrequent attenders, frequent attenders had a higher rate of presentations due to hepatic encephalopathy (15.2% vs 13.7%, P < 0.001) and ascites (10% vs 4%, P < 0.001) and ascites (10% vs 4%, P < 0.001) and ascites (10% vs 4%.

Conclusions: Hepatic encephalopathy and ascites account for more ED visits in frequent than in infrequent attenders. Our findings provide information for those planning outpatient support for patients with cirrhosis. Further research is warranted.