Original articlePancreas, biliary tract, and liver: EditorialPalliative Care and End-Stage Liver Disease
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Hospital Opioid Usage and Adverse Events in Patients With End-Stage Liver Disease
2023, Journal of Pain and Symptom ManagementCitation Excerpt :Our study highlights a clinically vulnerable population as the average MELD-Na score was 24.2, which is associated with a 35 percent risk of 6-month mortality.36 This patient population suffers from poor quality of life and there has been a call for more palliative care involvement in the past decade.37,38 Palliative care is a type of medical care that focuses on symptom management, including pain control, and on elucidating patients’ health care goals in light of their advanced illnesses.
Psychosocial evaluation for liver transplantation: A brief guide for gastroenterologists
2021, Revista de Gastroenterologia de MexicoIntegrated Model for Patient-Centered Advanced Liver Disease Care
2020, Clinical Gastroenterology and HepatologyCitation Excerpt :Some patients avoid discussing prognosis or acknowledging the possibility of death; lack of communication about prognosis can leave patients uncertain, unprepared, and unable to cope. In general, patients expect their clinicians to initiate discussions about end-of-life care, but literature suggests that providers may avoid or truncate these important conversations.29 Clinicians’ approaches to supportive and palliative care in AdvLD are the starting point for developing patient-centered models, yet little is known about their experiences with the collaborative planning process.
Patterns of palliative care utilization among patients with end stage liver disease during end-of-life hospitalizations: A population-level analysis
2018, Journal of Critical CareCitation Excerpt :First, prevalent uncertainties about the disease process and its outcomes among patients with ESLD and their family members may reduce their ability to cope with progressing illness and to consider data-driven goals of care during crisis events [1]. Second, given the reported misconceptions by patients and their family members about palliative care as essentially giving up on further care [33,34], it was suggested that as patients' severity of illness worsens, the mere potential of life-extending interventions (e.g., transfer to ICU, use of life support interventions, and the prospect of liver transplantation [even if implausible]) may eliminate consideration of any other intervention that does not focus on extending life [33] and increase preference for aggressive care [35]. Third, there is prevalent overestimation of survival among patients with ESLD and their surrogates during EOL hospitalization [2], which may adversely affect their decision-making.
Palliative support in patients with advanced liver disease: Focus on needs rather than prognosis
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Conflicts of interest The authors disclose no conflicts.
Funding Anne Walling is supported by the National Institutes of Health/National Center for Advancing Translational Science (NCATS), University of California, Los Angeles (UCLA), Clinical and Translational Science Institute (CTSI) (grant KL2TR000122). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.