Palliative medicine and hospital readmissions in end-stage liver disease
Bibliographic record
Abstract
BACKGROUND: Patients with end-stage liver disease (ESLD) have a reduced life expectancy and a significant symptom burden. Our aim is to determine if inpatient palliative care (PC) referral for patients with ESLD is associated with decreased hospital readmission rates. METHODS: The 2013 US Nationwide Readmission Database (NRD) was used for the current analysis. The NRD allows for longitudinal analysis of all patient hospital admissions across 22 states. Patients ≥18 years of age with a diagnosis of ESLD with at least two decompensating events were included in the analysis. PC referral at the index hospitalisation divided the cohort into two groups, which were tracked for 9 months. RESULTS: A total of 14 325 172 hospital admissions from the 2013 NRD were examined. In the first 3 months of 2013, a total of 3647 patients with ESLD were admitted with 206 (5.6%) receiving PC referral during the index admission. After the index hospitalisation, patients referred to PC were more likely to be discharged to skilled nursing facilities (45.5% vs 14.7%; p<0.01) or hospice/home care (32.9% vs 15.3%; p<0.01). After propensity score matching, those patients referred to PC demonstrated a significantly lower rate of 1-year hospital readmission (11.0% vs 32.1%; p<0.01). CONCLUSION: Inpatient PC referral for patients with ESLD was associated with lower rates of hospital readmission. Early concurrent PC referral likely has added beneficial effects beyond quality of life issues and symptom management.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".