In Liguria, the ASL 3 has developed a Diagnostic Therapeutic Assistance Pathway (Pdta) on hepatic encephalopathy in cirrhotic patients. It is a serious complication of cirrhosis, which manifests itself in a more or less relevant way. Specifically, it is a serious neurological problem that occurs when the liver stops performing one of its most important functions: detoxification.
Liver cirrhosis causes about 400 deaths a year: it is the first cause of liver transplantation in the region which – explains a note released by Alfasigma – is in seventh place in Italy for mortality from cirrhosis and liver cancer. Weighs the high alcohol consumption. According to data from the Higher Institute of Health, in Liguria, one out of 4 men and one out of 10 women consume alcohol in a way that is dangerous to their health. There are an estimated 5,100 cases of cirrhosis of the liver, 60% of which are probably due to alcohol. Hepatic encephalopathy is the most frequent cause of improper hospitalizations and, after a discharge, 50% of patients return to the hospital again, for the same reasons, within 90 days.
The Pdta of the ASL 3 identifies, as recommendations for the management of the patient with liver cirrhosis, the active involvement of general practitioners, hospital, transplantation and nurses activities. “We have developed the new model – says the general manager, Luigi Carlo Bottaro – by applying the principles of ‘sharing medicine’ which places the needs and requests of the patient, family members and associations at the center of the process, which, together with the healthcare, represent the cornerstones of the entire system of care.We were able to carry out this initiative thanks to the great experience in the sector of liver diseases which, combined with the profound knowledge of the territory, allows us today a more adequate management of the patient suffering from cirrhosis of the liver. pathology which, like all chronic diseases, strongly affects the quality of life of the patient and his family”.
“The strengths of this path – underlines Gianni Testino, head of Sc Addiction and Hepatology Asl 3 and president of the Italian Society of Alcohol (SIA) – are represented by a multidisciplinary management of the patient, a close collaboration with the transplant organization, the introduction of an innovative method for the training and support of the family and, in particular, of caregivers. In fact, a formal caregiver will be introduced within the department, a figure who manages the training and support of family members, but above all it represents a ‘bridge’ between the family and the medical-nursing team.The preliminary results tell us that there is a significant reduction in the emotional and organizational overload of the family caregiver and, above all, the cases of improper hospitalizations are reduced to minimal percentages “.
The prevalence of liver cirrhosis nationwide – reports the note – is 0.3% and the disease represents the seventh cause of death in Italy. Overall, there are about 200,000 cases of cirrhosis and about 33,000 cases of liver cancer, while more than 21,000 deaths per year are caused by cirrhosis and liver cancer, considered globally. 80% of deaths from liver disease and 60% of those from cirrhosis of the liver are caused by alcohol. Liver cancer is the third cause of cancer death.