Admission Care Bundle for Decompensated Cirrhosis

This was the first ToRcH-UK project and it marked the creation of the 1st national UK hepatology trainee network. The background to this study is that the morbidity and mortality from chronic liver disease has significantly increased in recent times. An NCEPOD report demonstrated that less than 50% of admissions with alcohol related liver disease received good care. The British Society of Gastroenterology (BSG)/ British Association for the Study of Liver Disease (BASL) admission bundle was subsequently developed and shown to improve inpatient care. This study aimed to retrospectively audit the uptake of the bundle in November 2019 across UK hospitals, as well as determine its impact on patient outcomes.

The project was a huge success with 104 hospitals involved in data collection, with a total of 1,224 admissions. The results showed that utilisation of the bundle was low across the UK (11.44%) with significant regional variation but that it did improve standards of care. These findings were published in Clinical Medicine, and this has led to an updated admission bundle, which has recently been published in Frontline Gastroenterology. Additionally, this work has fed into the quality standards work that is currently ongoing through the BSG liver section, as well as contributed to UK Chronic Liver Failure Network research.