title: Rehabilitation for cirrhotic patients discharged after hepatic encephalopathy improves survival.
abstract: BACKGROUND
  The 1-year mortality of cirrhotic patients with hepatic encephalopathy (HE) is approximately 60-80% in recent studies. We aimed to establish a rehabilitation out-patient clinic (RC) for alcoholic cirrhotic patients sur-viving HE.
  
  
  METHODS
  Prospectively, patients surviving HE were offered participation in the RC and were seen by a nurse for a one-hour interview with 1-3 weeks' interval after discharge and by a physician, if needed. Clinical, psychological and social problems were identified and addressed. Alcohol consumption was recorded and alcohol cessation was encouraged at each visit. Minimal or overt HE prompted referral to the Liver Unit. The patients were compared with HE patients discharged in 2008 (the control group).
  
  
  RESULTS
  A total of 19 patients were included in the RC group and compared with the 14 patients of the control group. The Child-Pugh score was higher in the RC group (median 13; range 8-14) than in the control group (median 11; range 7-13) (p = 0.033), whereas other clinical, demographic and biochemical parameters did not differ between the two groups. One-year survival was higher in the RC group (16/19; 84%) than in the control group versus (5/14; 36%) (p = 0.012). The log-rank test confirmed an improved survival for the RC group (p = 0.008). The economic costs of subsequent hospital admissions did not differ between the two groups. In the RC group, alcohol consumption was reduced in all but two patients.
  
  
  CONCLUSIONS
  Survival was significantly improved for patients in the rehabilitation clinic. The improved survival did not subsequently cause higher hospital admission costs.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Department of Gastroenterology and Hepatology, Bispebjerg Hospital, 2400 Copenhagen NV, Denmark.
authors.forename: Michala Maj
authors.initials: MM
authors.lastname: Andersen
authors.forename: Søren
authors.initials: S
authors.lastname: Aunt
authors.forename: Nanna Martin
authors.initials: NM
authors.lastname: Jensen
authors.forename: Christian
authors.initials: C
authors.lastname: Homann
authors.forename: Joan
authors.initials: J
authors.lastname: Manniche
authors.forename: Svend
authors.initials: S
authors.lastname: Svendsen
authors.forename: Erik
authors.initials: E
authors.lastname: Christensen
authors.forename: Astrid
authors.initials: A
authors.lastname: Reher-Langberg
authors.forename: Frank Vinholt
authors.initials: FV
authors.lastname: Schiødt
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control; D000553:Ambulatory Care; D058625:End Stage Liver Disease / Q000401:mortality / Q000534:rehabilitation; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000401:mortality* / Q000534:rehabilitation*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000401:mortality* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics; D012720:Severity of Illness Index; D012947:Social Work; D015996:Survival Rate