Protopapas AA, Tsankof A, Papagiouvanni I, Kaiafa G, Skoura L, Savopoulos C, Goulis I. Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide. World J Hepatol 2024; 16(12): 1377-1394 [DOI: 10.4254/wjh.v16.i12.1377]
Corresponding Author of This Article
Adonis A Protopapas, MD, MSc, Doctor, First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kiriakidi 1, Thessaloniki 54636, Greece. adoprot@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Dec 27, 2024; 16(12): 1377-1394 Published online Dec 27, 2024. doi: 10.4254/wjh.v16.i12.1377
Outpatient management after hospitalisation for acute decompensation of cirrhosis: A practical guide
Adonis A Protopapas, Alexandra Tsankof, Ioanna Papagiouvanni, Georgia Kaiafa, Lemonia Skoura, Christos Savopoulos, Ioannis Goulis
Adonis A Protopapas, Alexandra Tsankof, Georgia Kaiafa, Christos Savopoulos, First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece
Ioanna Papagiouvanni, Ioannis Goulis, Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece
Lemonia Skoura, Department of Microbiology, Aristotle University οf Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece
Author contributions: Protopapas AA, Tsankof A, Papagiouvanni I, Savopoulos C, and Goulis I contributed to the conception and design of this manuscript; Protopapas AA and Tsankof A drafted the article; Protopapas AA, Tsankof A, Kaiafa G, Skoura L, Savopoulos C, and Goulis I contributed to the critical revision of the article for important intellectual content; and all authors approved the final article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Adonis A Protopapas, MD, MSc, Doctor, First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Stilponos Kiriakidi 1, Thessaloniki 54636, Greece. adoprot@hotmail.com
Received: June 12, 2024 Revised: October 24, 2024 Accepted: November 20, 2024 Published online: December 27, 2024 Processing time: 169 Days and 20.5 Hours
Abstract
Acute decompensation in cirrhotic patients signifies the onset of clinically evident events due to portal hypertension. The transition from compensated to decompensated cirrhosis involves hemodynamic changes leading to multiorgan dysfunction, managed predominantly in outpatient settings with regular monitoring. The mortality risk is elevated in decompensated patients. Therefore, diligent outpatient management should focus on regular medical follow-ups, medication adjustments, patient education, addressing emergent issues and evaluation for liver transplantation. The ultimate goal is to improve quality of life, prevent disease progression, reduce complications, and assess possible recompensation. This guide provides valuable recommendations for medical experts managing decompensated cirrhotic patients post-hospitalization.
Core Tip: Decompensation in patients with cirrhosis is associated with higher morbidity and mortality. Apart from managing these patients during hospitalisation, it is equally important to provide them with effective outpatient care. Regular medical follow-ups after hospitalisation due to acute decompensation are essential for monitoring the condition of decompensated patients with cirrhosis, while a multidisciplinary approach can prevent disease progression and optimise patient outcomes.
