Incidence and predictors of 30-day hospital readmissions for liver cirrhosis: insights from the United States National Readmissions Database

作者：Sushil Kumar Garg, Hemant Goyal, Itegbemie Obaitan, Pir Ahmad Shah, Shashank Sarvepalli, Loretta Jophlin, Dupinder Singh, Sumeet K. Asrani, Patrick S. Kamath, Michael D. Leise · 发表于：Annals of Translational Medicine · 年份：2021 · DOI：10.21037/atm-20-1762 · 被引用次数：45 · 研究领域：Liver Disease and Transplantation、Heart Failure Treatment and Management、Nutrition and Health in Aging

BACKGROUND: Cirrhosis is associated with substantial inpatient morbidity and mortality. This study aimed to determine the trends in 30-day hospital readmission rates among patients with cirrhosis and identify factors associated with these readmissions. METHODS: We conducted a retrospective analysis of data retrieved from the Nationwide Readmissions Database to determine trends in 30-day readmission for patients discharged with a diagnosis of cirrhosis in 2010 through 2014. Multivariate logistic regression analysis was used to identify predictors of readmission. RESULTS: Among 303,346 patients identified from the database, the 30-day readmission rate for patients with a discharge diagnosis of cirrhosis was 31.4% (n=95,298). The trends in the readmission rates remained steady during the study period. On multivariate analysis, female sex, age 45 years or older, esophagogastroduodenoscopy (EGD) during admission, and disposition to a short-term care facility or skilled nursing facility protected against readmissions. In contrast, coverage by Medicaid insurance, admission during a weekend, nonalcoholic cause of cirrhosis, and history of hepatic encephalopathy and ascites were associated with readmission. CONCLUSIONS: We found an exceptionally high 30-day readmission rate in patients with cirrhosis, although it remained stable during the study period. This study identified some modifiable factors such as disposition to a short-term care facility or skilled nursing facility and patie...