Standardizing Care in Decompensated Cirrhosis

Decompensated cirrhosis is a critical stage of liver disease associated with high morbidity and mortality. Significant variability in care exists, potentially impacting patient outcomes. This study aimed to evaluate the effectiveness of a standardized admission care bundle in improving outcomes for patients with decompensated cirrhosis. Quasi-experimental research design was utilized in the study. Gastroenterology intensive care unit (ICU) at Al-Rajhy Liver Hospital at Assiut University, Assiut, Egypt. The study included 180 patients with decompensated cirrhosis, comparing outcomes between a control group (received routine hospital care, n = 90) and study group (received admission care bundle, n = 90) of a standardized admission care bundle. The bundle comprised early risk stratification, timely antibiotics administration, prompt fluid assessment, variceal bleeding prophylaxis, and hepatic encephalopathy management. Primary outcomes included mortality rate and length of gastroenterology ICU stay. Secondary outcomes included the occurrence of specific complications. Compared to the control group, the post-implementation cohort demonstrated a significant reduction in mortality (38% vs. 18.9% respectively) (P < .05). Also observed was a statistically significant decrease in the average length of hospital stay and occurrence of complication (P < .01). Implementation of a standardized admission care bundle for decompensated cirrhosis is associated with improved patient outcomes, specifically a reduction in 90-day mortality and length of stay, highlighting the potential of standardized care to enhance the management of this complex condition.