HOSPICE LIVER
DISEASE
The patient
should show both (a) and (b):
a. Prothrombin
time prolonged more than 5 seconds over control, or International
Normalized Ratio (INR)>1.5
b. Serum albumin <2.5 gm/d1
2. End stage
liver disease is present and the patient shows at least one of the following:
a. ascites,
refractory to treatment or patient non-complaint
b. spontaneous
bacterial peritonitis
c. hepatorenal
syndrome (elevated creatine and BUN with oliguria (<400ml/day) and urine sodium
concentration <10 mEq/l)
d. hepatic
encephalopathy, refractory to treatment, or patient non-complaint
e. recurrent
variceal bleeding, despite intensive therapy
3.
Documentation of the following factors will support eligibility for hospice
care:
a. progressive
malnutrition
b. muscle
wasting with reduced strength and endurance
c. continued
active alcoholism (>80 gm ethanol/day)
d.
hepatocellular carcinoma
e. HBsAg
(Hepatitis B) positivity
f. hepatitis C
refractory to interferon treatment
If you have any
questions please call
Grace Hospice
of