Outcomes in Cirrhosis-Related Refractory Ascites with Emphasis on Palliative Care: Single-Centre Experience and Literature Review

Despite refractory ascites (RA) due to cirrhosis having a median transplant-free survival of 6–12 months, palliative care (PC) input remains uncertain. We aimed to review the existing literature on clinical outcomes in cirrhosis-related RA and report the findings of a single-centre retrospective cohort study with a special focus on linkage to PC in this cohort of patients.

Our study and subsequent literature review confirm the high mortality associated with cirrhosis-related RA (19–55% 1-year mortality) with only a minority of patients receiving curative options (3–23%). Despite this, in our study only a minority of patients (33%) were referred to PC. None of the studies identified in the scoping review makes any references to palliative care use.

Our own data and a literature review confirm that, despite high mortality, only a minority with RA due to cirrhosis are referred for specialist PC input and often too late in their disease trajectory. Future research should focus on patient-centred outcomes in this cohort of patients where optimising quality-of-life and facilitating advanced care planning should be a priority.