Abstract No. 236 Characteristics Predictive of 30-Day Readmission and Mortality After Transarterial Chemoembolization

To evaluate factors predictive of 30 day readmission and mortality in those who have undergone transarterial chemoembolization (TACE). Single-institution retrospective analysis of patients who underwent TACE for hepatocellular carcinoma (HCC) between January 2019 and June 2022. Either conventional (cTACE) or drug-eluting beads (DEB) TACE were performed in a usual fashion. Patients were discharged home the same day or kept overnight at discretion of interventional radiologist. Univariate logistics analysis was performed to assess for factors predictive of 30 day readmission and mortality. Multivariable logistic regression was performed on factors that showed p< 0.1 in the univariate analysis. 348 patients underwent 529 TACE procedures. There were 36 readmissions within 30 days of procedure (6.8%). 30 day mortality was 1.9% after TACE (n=10). On univariate analysis, 30 day readmission was associated with Child-Pugh score (odds ration [OR] 1.4, confidence interval [CI] 1.12-1.75, p=0.0032), MELD (OR 1.13, CI 1.04-1.23, p=0.0031), MELD Na (OR 1.12, CI 1.04-1.19, p=0.0014), albumin level (OR 0.52, CI 0.28-0.96, p=0.0354), INR (OR 11.6, CI 2.58-52.06, p=0.0014), ascites (OR 3.03, CI 1.31-6.97, p=0.0155), and procedural complications (OR 9.10, CI 3.7-21.40, p< 0.0001). 30 day mortality was associated with Child-Pugh score (OR 1.58, CI 1.06-2.35, p=0.0252), lobar TACE (OR 4.35, CI 1.20-15.8, p=0.0256), and procedural complication (OR 12.64, CI 3.36-47.57, p=0.0002). Factors not associated with either endpoint included age, sex, Charleson comorbidity index, HCC stage, encephalopathy, ECOG status, anesthesia level and type of TACE (cTACE vs. DEB TACE). Same day discharge was not predictive of 30 day readmission or mortality (OR 0.68, CI 0.34-1.37, p=0.2794 and OR 0.66, CI 0.18-2.38, p=0.528 respectively). Multivariable regression showed MELD Na score (OR 1.11, CI 1.04-1.20, p=0.0027) and procedural complications (OR 8.81, CI 3.67-21.13, p< 0.001) were associated with 30 day readmission. Multivariable regression confirmed factors associated with 30 day mortality were Child-Pugh Score (OR 1.84, CI 1.15-2.92, p=0.0106), low platelets (OR 1.10, CI 1.00-1.01, p=0.0111), lobar TACE (OR 4.28, CI 1.05-17.40, p=0.0422), and procedural complications (OR 12.12, CI 2.87-51.23, p=0.0007). Poor liver function and procedural complication are associated with 30 day readmission and mortality. Lobar TACE is independently associated with 30 day mortality. Same day discharge does not increase the risk of short-term readmission or mortality.