Paracentesis underutilized in patients with cirrhosis, ascites

(HealthDay)—For patients admitted with diagnoses of cirrhosis and ascites, paracentesis is associated with decreased in-hospital mortality but is underutilized, according to a study published online Dec. 8 in the Journal of Gastroenterology and Hepatology.

John N. Gaetano, M.D., from the University of Chicago, and colleagues identified 31,614 adults, non-electively admitted with diagnoses of cirrhosis and ascites. Utilization and outcomes of paracentesis were examined.

The researchers found that 51 percent of the hospitalized patients underwent paracentesis. The overall in-hospital mortality rate was 7.6 percent, with increased mortality seen among patients who did not versus those who did undergo paracentesis (8.9 versus 6.3 percent; P < 0.001). In-hospital mortality was 1.83-fold higher for patients who did not receive paracentesis versus those who did receive paracentesis. There was a reduction in mortality for early paracentesis versus late paracentesis (5.5 versus 7.5 percent). Less frequent use of early paracentesis was seen for patients admitted on a weekend (50 versus 62 percent for those admitted on a weekday; adjusted odds ratio, 1.12). Early paracentesis correlated with shorter length of stay and decreased hospitalization costs among patients diagnosed with spontaneous bacterial peritonitis (both P < 0.001).

"[These data support] the use of paracentesis as a key inpatient quality measure among hospitalized adults with cirrhosis," the authors write. "Future studies are needed to investigate the barriers to paracentesis use on admission."