LB050 - REGULAR SPECIALIST DIETETIC INTERVENTION CAN REDUCE DAY CASE PARACENTESIS FREQUENCY

LB050

REGULAR SPECIALIST DIETETIC INTERVENTION CAN REDUCE DAY CASE PARACENTESIS FREQUENCY

K. Weatherby^1,*, T. Nyirenda¹, S. Moreea¹

¹Bradford Teaching Hospital Foundation Trust , Bradford , United Kingdom

Rationale: Patients with decompensated cirrhosis & refractory ascites requiring regular paracentesis are often sarcopenic & malnourished with an increased risk of morbidity & mortality. Our specialist liver dietitian started to provide a regular bespoke service to patients attending day case paracentesis, therefore we wanted to evaluate if this improved patient outcomes.

Methods: A retrospective audit was carried out between Sep 22 -Aug 23 (Y1) when there was limited dietetic input. Compared to Sep 23-Aug 24 (Y2) where regular specialist dietetic service was provided. We obtained the following data using our electronic records.

Results: in Y1, 232 drains were placed with 33 patients (Pt) (21M (63.6%), age range 36-75, mean age 60; 12F, age range 45-89, mean age 72; average 7 drains/Pt). 5 (15%) patients received an average of 1.2 dietetic episodes (n=6). In Y2 drain numbers halved to 116 drains with 31 patients (18M (58.1%), age range 35-84, mean age 61; 13F, age range 30-86, mean age 69; average 3.75 drains/Pt). 19 (61%) patients received an average of 2.9 dietetic episodes (n=55). Main diagnoses; ARLD (58% & 61%) & MASH (24% & 20%). 5 pts in Y1 received a long term drain & 6 in Y2.
The main finding showed fewer patients required 10 drains or more in Y2. In Y1, 6 patients required an average of 24.5 drains, average dietetic input per patient of 0.67 encounters. Outcomes for this patient group; 1 diuretic controlled ascites, 1 ongoing decompensation, 1 liver transplant (LT), 3 mortality. In Y2, 3 patients required an average of 16.3 drains, average dietetic input per patient of 8 encounters. Outcomes for this patient group; 1 diuretic controlled ascites, 1 TIPPS, 1 LT.

Conclusion: Our data shows proactive dietetic input delivered during day case paracentesis can reduce drain frequency, improve patient experience & importantly reduced costs (PBR for paracentesis £749, a saving of at least £75 000 from Y1 to Y2).

Disclosure of Interest: None declared