2 research outputs found
Liver stiffness as surrogate parameter in emergency assessment for inpatient health care utilization
Background
Transient elastography (TE) allows non-invasive quantification of liver stiffness (LSM) and
steatosis (controlled attenuation parameter, CAP). Here we test the feasibility and utility of
TE in the emergency department (ED) and investigate whether LSM predicts longer hospitalization and reimbursement for non-elective patients.
Methods
LSM and CAP were determined in prospectively recruited consecutive adult patients admitted to the ED of a tertiary referral center. Patients were stratified according to the 9.1 kPa
and 13.0 kPa LSM cut-offs. Elastography measurements were correlated with clinical and
outcome parameters, including duration of hospital stay and hospitalization costs.
Results
In 200 ED patients (133 men, age 18 – 97 years), median LSM was 5.5 kPa (2.4 – 69.1
kPa), and median CAP was 252 dB/m (100 – 400 dB/m). In total, 39 patients (19.5%) presented with LSM 9.1 kPa, and 24 patients (12.0%) presented with LSM 13.0 kPa. Heart
failure (n = 19) was associated with higher LSM (p = 0.045). Patients with LSM 9.1 kPa
were significantly (p < 0.01) more likely to require longer hospitalization than those with
lower LSM. Patients with LSM 13.0 kPa generated significantly (p = 0.001) higher costs
as compared to patients with low LSM.
Conclusions
Transient elastography represents an easily accessible screening tool in ED that might help
identify patients in need of increased health care resources