Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
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Clin. Gastroenterol. Hepatol. · Oct 2018
National Early Warning Score Accurately Discriminates the Risk of Serious Adverse Events in Patients With Liver Disease.
The National Early Warning Score (NEWS) is used to identify deteriorating adult hospital inpatients. However, it includes physiological parameters frequently altered in patients with cirrhosis. We aimed to assess the performance of the NEWS in acute and chronic liver diseases. ⋯ The NEWS accurately discriminates patients at risk of death, admission to the intensive care unit, or cardiac arrest within a 24-hour period for a range of liver-related diagnoses. Its widespread use provides a ready-made, easy-to-use option for identifying patients with liver disease who require early assessment and intervention, without the need to modify parameters, weightings, or escalation criteria.
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Clin. Gastroenterol. Hepatol. · Oct 2018
Review Meta AnalysisEfficacy of Treatments for Opioid-Induced Constipation: Systematic Review and Meta-Analysis.
Opioid-induced constipation (OIC) is a common problem in patients on chronic opioid therapy for cancer-related and non-cancer-related pain. Approved treatments for OIC are methylnaltrexone, naloxone, naloxegol, alvimopan, naldemedine, and lubiprostone. Since a meta-analysis performed in 2014, 2 new agents have been approved by the Food and Drug Administration for treatment of OIC (naloxegol and naldemedine). ⋯ In a systematic review and meta-analysis, we found μ-opioid-receptor antagonists to be safe and effective for the treatment of OIC. Prescription-strength laxatives (prucalopride, lubiprostone) are slightly better than placebo in reducing OIC.
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Clin. Gastroenterol. Hepatol. · Oct 2018
Positive Predictive Value of International Classification of Diseases, 10th Revision, Codes for Cirrhosis and Its Related Complications.
Large administrative databases using International Classification of Diseases (ICD) codes are useful for epidemiologic, health services, and outcomes research.1,2 However, coding accuracy of disease conditions could be a limiting factor. Cirrhosis prevalence is increasing because of an aging hepatitis C cohort and an increase in nonalcoholic steatohepatitis.3 We previously examined the validity of ICD, 9th revision (ICD-9), codes for cirrhosis in US Department of Veterans Affairs (VA) administrative databases.4,5 This work has formed the basis for many clinical, epidemiologic, and health services research studies. However, with transition from the ICD-9 to ICD, 10th revision (ICD-10), coding system, it is important to determine the validity of these new cirrhosis codes in administrative databases. Although the greater number of codes in the ICD-10 system may be associated with greater specificity and coding accuracy than with the ICD-9 system, this hypothesis remains untested.