Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

An Automated Telephone Monitoring System to Identify Patients with Cirrhosis at Risk of Re-hospitalization.

Thomson M, Volk M, Kim HM, Piette JD. An Automated Telephone Monitoring System to Identify Patients with Cirrhosis at Risk of Re-hospitalization. Digestive diseases and sciences. 2015 Dec 1; 60(12):3563-9.

Related HSR&D Project(s)

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


BACKGROUND AND AIMS: Hospitalizations for cirrhosis are costly and associated with increased mortality. Disease management outside of clinic, such as the use of interactive voice response (IVR) calls, may identify signs to prevent hospitalization. The aim of this study was to investigate whether IVR monitoring can predict hospitalization and mortality in cirrhosis. METHODS: One hundred patients with decompensated cirrhosis were enrolled in this observational study, of which 79 patients were included in the final analysis. Participants were followed until death, transplant, or last clinical follow-up (range 7-874 days). Analysis focused on potential predictors identified during the first month of IVR calls: presence of jaundice, abdominal/leg swelling, weakness, paracentesis requirement, medication changes, and weight change. The primary outcome was time to first hospital admission; secondary outcomes included hospitalization and time to death. Potential predictors with a p value < 0.1 were further analyzed after adjustment for covariates (Model for End-stage Liver Disease score, serum sodium, number of medications). RESULTS: Twenty (25%) patients died, and 49 (62%) were hospitalized at least once. Fifty-six (70%) patients completed > 80% of their IVR calls. After adjustment for covariates, weakness was associated with an increased risk of first hospitalization (HR 2.14, CI 1.13-4.05, p = 0.02) and hospitalization rate (HR 2.1, CI 1.0-4.3, p = 0.048). Weight change of = five pounds (2.3 kg) in a week increased the rate of hospitalization by 2.7 (CI 1.0-7.1, p = 0.045). No variable predicted death after covariate adjustment. CONCLUSIONS: These results suggest IVR calls can be used to predict hospitalization in cirrhosis.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.