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Outcomes in Cirrhosis-Related Refractory Ascites with Emphasis on Palliative Care: Single-Centre Experience and
Marcus Rex English1, Jordache Ellis2, Sumita Verma1,2
1Department of Gastroenterology and Hepatology, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
Purpose Of Review:
Despite refractory ascites (RA) due to cirrhosis having a median transplant-free survival of 6-12 months, palliative care (PC) input remains uncertain. We aimed to review the existing literature on clinical outcomes in cirrhosis-related RA and report the findings of a single-centre retrospective cohort study with a special focus on linkage to PC in this cohort of patients.
Recent Findings:
Our study and subsequent literature review confirm the high mortality associated with cirrhosis-related RA (19-55% 1-year mortality) with only a minority of patients receiving curative options (3-23%). Despite this, in our study only a minority of patients (33%) were referred to PC. None of the studies identified in the scoping review makes any references to palliative care use.
Summary:
Our own data and a literature review confirm that, despite high mortality, only a minority with RA due to cirrhosis are referred for specialist PC input and often too late in their disease trajectory. Future research should focus on patient-centred outcomes in this cohort of patients where optimising quality-of-life and facilitating advanced care planning should be a priority.
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