Cirrhosis Readmission Telehealth Project

The purpose of this randomized prospective pilot study is to decrease hospital readmissions
for patients with hepatic encephalopathy. Patients who were admitted at YNHH with hepatic
encephalopathy will be enrolled. Patients will then be randomized to one of two groups upon
discharge. The control group will receive usual standard of care for hepatic encephalopathy
(encephalopathy education, cirrhosis brochure, stool chart, and routine follow up with their
primary care provider and hepatologist). The intervention group will receive usual standard
of care as discussed above and phone calls for a 3-month period after their hospitalization.

Inclusion Criteria:

- Age of at least 18

- Patients with known cirrhosis

- Current hospitalization for overt hepatic encephalopathy as categorized by West Haven
encephalopathy score of 2 or more

- Current hospitalization found no precipitants triggering encephalopathy as determined
by the primary team

- Encephalopathy resolved at time of enrollment

- Has a telephone

- Able to obtain medications

Exclusion Criteria:

- Altered mental status unrelated to cirrhosis

- Acute liver failure

- Expectation of liver transplant within 1 month after enrollment

- Chronic kidney disease with Cr > 2 mg/dL

- Respiratory insufficiency:moderate to sever COPD on pulmonary function test

- Electrolyte imbalances not corrected at enrollment

- Sodium less than 125 mmol/L

- Calcium greater than 10mg/dL

- Potassium < 2.5mmol/L

- Unable to give legal consent

- Deafness

- Infection, spontaneous bacterial peritonitis, gastrointestinal bleeding