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The Role of Palliative Care in Cirrhosis

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The Critically Ill Cirrhotic Patient

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Abstract

Cirrhosis is a significantly life-limiting disease, and once a cirrhotic patient has decompensated into critical illness and hospitalization, annual mortality rates become quite high with median survival ≤6 months when MELD scores are ≥21. This chapter will review palliative care concepts in the support and treatment of cirrhotic patients. At the outset, it is essential to note that palliative care is not only the responsibility of palliative care specialists but also of hepatologists, gastroenterologists, hospitalists, or any health-care professional caring for seriously ill patients. A contemporary definition of palliative care including its relationship to hospice will be offered along with reflection on the evolution and the benefits of this relatively new (2008) board-certified specialty. The six common tasks of palliative care, whether provided by the hepatologist or the palliative care specialist, will then be reviewed, with a focus on serious illness communication and advance care planning. Finally, this chapter will close with a review of opioid use in the setting of end-stage liver disease and terminal care of the dying cirrhotic.

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Authors and Affiliations

  1. Office of Clinical Ethics and Palliative Care, Baylor Scott and White Health, Temple, TX, USA

    Robert L. Fine

  2. Departments of Humanities and Internal Medicine, Texas A & M College of Medicine, Bryan, TX, USA

    Robert L. Fine

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  1. Robert L. Fine
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Correspondence to Robert L. Fine .

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Editors and Affiliations

  1. Texas A&M Health Science Center, Baylor University Medical Center, Dallas, TX, USA

    Robert S. Rahimi

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Fine, R.L. (2020). The Role of Palliative Care in Cirrhosis. In: Rahimi, R. (eds) The Critically Ill Cirrhotic Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-24490-3_16

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  • DOI: https://doi.org/10.1007/978-3-030-24490-3_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24489-7

  • Online ISBN: 978-3-030-24490-3

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