Cirrhosis in primary practice: many patients remain potentially undiagnosed and are not receiving liver cancer surveillance
Rattachement africain : au, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND AND AIM: Most patients with cirrhosis have compensated disease and are cared for in primary care; however, the exact epidemiology within Australia remains largely unknown. The aim of this study was to assess cirrhosis care in an Australian primary care setting by evaluating rates of cirrhosis diagnosis, appropriate hepatocellular carcinoma (HCC) surveillance and specialist communication. METHODS: Electronic medical records in consenting general practices were reviewed using the "Liver Toolkit" to identify patients with an existing cirrhosis diagnosis. Individual cases were reviewed to identify outcomes of interest. RESULTS: One hundred seventy-one patients with confirmed cirrhosis across nine general practices were identified (74% male, mean age: 61.2 years). There was significant variation in the rate of cirrhosis diagnosis between practices (range 31.7-637.9 per 100 000 patients, P < 0.0001). Patients with cirrhosis had predominately compensated disease (75% Child-Pugh A) and common etiologies of cirrhosis were alcohol (49%), hepatitis C (47%), and metabolic dysfunction-associated steatotic liver disease (29%). Forty-two patients (25%) had received appropriate HCC surveillance. Predictors of inadequate HCC surveillance were time from last specialist correspondence (odds ratio [OR] = 1.06 per month increase, 95% confidence interval [CI]: 1.02-1.10, P = 0.002) and hepatitis B (OR = 0.24, 95% CI: 0.06-0.98, P = 0.047). Specialist correspondence with primary care was older than 2 years or absent in 37% of cases. CONCLUSIONS: There was a 20-fold difference in the rate of cirrhosis diagnosis between general practices within Sydney, suggesting a large proportion of patients remain undiagnosed. Three quarters of patients with diagnosed cirrhosis are not receiving appropriate HCC surveillance.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Cirrhosis in primary practice: many patients remain potentially undiagnosed and are not receiving liver cancer surveillance
- Date Crossref
- 24/10/2024
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Royal Prince Alfred Hospital AW Morrow Gastroenterology and Liver Centre pays non établi dans la noticeÉtablissement de santé
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Centenary Institute Liver Injury and Cancer Program pays non établi dans la noticeStructure de recherche
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Liverpool Hospital Department of Gastroenterology and Liver pays non établi dans la noticeÉtablissement de santé
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UNSW Sydney pays non établi dans la noticeUniversité ou école supérieure
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St George's Hospital pays non établi dans la noticeÉtablissement de santé
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St George Hospital Department of Gastroenterology and Hepatology pays non établi dans la noticeÉtablissement de santé
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South Eastern Sydney Local Health District pays non établi dans la noticeÉtablissement de santé
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St Vincent's Hospital Sydney pays non établi dans la noticeÉtablissement de santé
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The University of Sydney pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Medicine and Health The University of New South Wales Sydney New South Wales Australia pays non établi dans la noticeUniversité ou école supérieure
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Central and Eastern Sydney Primary Health Network Mascot New South Wales Australia pays non établi dans la noticeInstitution
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East Sydney Doctors Darlinghurst New South Wales Australia pays non établi dans la noticeInstitution
AW Morrow Gastroenterology and Liver Centre — Royal Prince Alfred Hospital, Liver Injury and Cancer Program — Centenary Institute et Department of Gastroenterology and Liver — Liverpool Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.