Details

Autor(en) / Beteiligte

• Turnbull, A
• Daniels, T
• Carroll, M.P
• Nash, K

Titel

261 Audit and improvement of the cystic fibrosis liver service in a regional adult CF unit

Ist Teil von

• Journal of cystic fibrosis, 2015-06, Vol.14, p.S125-S125

Ort / Verlag

Elsevier B.V

Erscheinungsjahr

2015

Link zum Volltext

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• Objectives CF related Liver Disease (CFRLD) is the third most frequent cause of death in people with CF (PWCF). The UK CF Trust estimates that 40% of PWCF have some liver abnormalities. Severe abnormalities can be a contra-indication to lung transplant. Early detection and treatment is essential to prevent/delay progression. Methods In 2013 an audit was performed to review practice using the following standards: – All patients should be screened for liver abnormality. – Any abnormalities in screening tests should be discussed with a Hepatologist and clinic review arranged if appropriate. Results There were 194 PWCF, including shared care (mean age 30.84, min 16, max 67, 101 female). 2 excluded as post liver transplantion, leaving 192 for analysis. Although 188/192 had had liver function tests in the last 12 months, only 91/192 (47%) received a liver ultrasound within the last 3 years and 17 had been reviewed by a hepatologist. Following this, a CFNS was charged with coordinating liver assessments, with a minimum of 3 yearly Liver ultrasound scans and yearly liver profile bloods. All results would be reviewed by the CFNS and further discussed with the hepatologist when abnormalities were detected. Re-audit was undertaken in 2015 (excluding shared care patients). 185/192 (97%) of all PWCF had had liver Ultrasound within the last 3 years. 85% of those with abnormalities were discussed with the hepatologist or seen in person with clear written management plans formulated. The number of patients recommended to start treatment had increased from 47 to 71. 7 patients were identified as having disease which may preclude lung transplant. Conclusion This approach improves liver care.