Effect of Multidisciplinary Team-Based Refined Nursing on Outcomes in Elderly Patients with Liver Cirrhosis and Upper Gastrointestinal Bleeding

The purpose of this study is to investigate how a multidisciplinary team (MDT)-based refined nursing approach enhances clinical outcomes (including hemostatic efficacy, nutritional improvement, psychological well-being, rebleeding rates, and life quality) in elderly liver cirrhosis (LC) patients complicated with upper gastrointestinal bleeding (UGIB). Using a prospective randomized controlled trial design, 120 elderly LC + UGIB patients (2023-2024) were randomized to receive either routine care (control group, n = 60) or MDT-based refined nursing (intervention group, n = 60). MDT-refined nursing includes 3-phase interventions: acute phase (24-72 h) with half-hourly vital sign monitoring and enteral nutrition initiation within 6 h of hemostasis; recovery phase (3-7 days) incorporating pharmacist-led medication reconciliation and biweekly psychotherapy; and 1-year follow-up with telemedicine support. The main outcome measures were hemostasis time, blood transfusion volume, blood pressure control, self-care ability, nutritional status, psychological well-being, short-term adverse events, 1-year rebleeding incidence, and quality of life. The results of the study showed that the intervention group showed better outcomes in hemostasis, nutrition, psychological status, and quality of life, but survival was unaffected. However, quality-of-life measures favored the intervention group. In conclusion, MDT-based refined nursing optimizes hemostasis efficiency, nutrition, and mental health in elderly LC patients with UGIB while lowering rebleeding risk and enhancing life quality.