In:
American Journal of Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 114, No. 1 ( 2019-10), p. S607-S607
Abstract:
Decompensated cirrhosis (DC) is an organ failure state associated with multiorgan involvement. Patients with cirrhosis are frequently readmitted, accounting for a significant portion of the billions of dollars spent annually in hospitalization for chronic liver disease. Various studies involving North American cohorts have reported a varied range of readmissions rates and predictors depending on the location and type of hospital. This study aimed to determine the rates of readmission and validate the predictors of 30 and 90-day readmission at a large rural tertiary care hospital with no liver transplant or hepatology service. METHODS: A retrospective chart review of patients with DC discharged from September 2016 to September 2018 was conducted. Patients with DC were identified through ICD- 10 codes listed as primary or secondary discharge diagnosis. Patient demographics, laboratory values, and disease-related risk factors were recorded. Primary outcomes were a 30- and 90-day inpatient readmission. We used multivariate logistic regression to determine predictors of readmission at 30 and 90-days. RESULTS: A total of 300 patient charts were selected randomly from a sample of 1500 identified through ICD codes. A total of 180 patients that met the inclusion and exclusion criteria were included for analysis. Mean age of the patients was 60.0 ± 11.8 years and 56.74 %were males. The most common etiology for cirrhosis was alcohol use (42.22%), and the mean MELD-Na score was 17 ± 11.8. Mean length of stay was 7 ± 6.6 days. The 30-day and 90- day readmission rate was 28% and 40% respectively. On multivariate analysis, GI bleed, (OR 8.5, 95% CI 2.7-27.2, P = 0.0003), infection, (OR 8.7, 95% CI 2.0-36.6, P = 0.0003) and electrolyte imbalance, (OR 6.6, 95% CI 1.8-24.6, P = 0.0005) were found to be independent predictors of readmission. CONCLUSION: Decompensated cirrhosis is associated with high rates of early and late readmissions at a large rural tertiary care hospital with no liver transplant or hepatology service. The predictors for readmission were also unique. Readmission rates and predictors should be reassessed locally so that structured interventions explicitly targeting the local hospital or region can be taken to prevent these readmissions.
Type of Medium:
Online Resource
ISSN:
0002-9270
,
1572-0241
DOI:
10.14309/01.ajg.0000593820.57923.25
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
