Missed diagnosis of cirrhosis in the inpatient setting

Abstract

Cirrhosis accounts for a large number of deaths in the United States and worldwide, leading to an increasing burden on the healthcare system. Cirrhosis is, however, a progressive disease with different potential complications related to liver dysfunction and portal hypertension. Often, patients may present with complications of cirrhosis without having been diagnosed previously. It is pertinent that clinicians recognize these signs to place patients on an appropriate course of management to help delay or avoid further disease progression while avoiding deleterious outcomes and unnecessary utilization. We will discuss the epidemiology of liver disease, cirrhosis, and its complications (hepatic encephalopathy, ascites, and varices). In this study, we will discuss the rationale and impact of missing these diagnoses on the healthcare system and patient.

Figure 1

Noninvasive assessment of cirrhosis Three of the major ways that cirrhosis can be detected noninvasively are using radiological signs of portal hypertension, indirect serological signs, and liver elastography. AST = Aspartate Aminotransferase, ALT = Alanine Aminotransferase