What is the clinical evidence from this study?

Study design: Cohort. Population: Cirrhosis (n=527). Intervention: Prior hospitalization within six months vs. No prior hospitalization within six months. Primary outcome: 30-day hospital readmission (OR 2.58, 95% CI 1.65-4.04, p=<0.001).

What question did this study set out to answer?

The study aims to identify factors predicting 30-day hospital readmission in patients with cirrhosis.

March 9, 2026Cureus0 citationsOpen Access

Predictors of 30-Day Readmission in Patients With Cirrhosis: A Retrospective Cohort Study

Q: What are the key findings of this study?

Prior hospitalization within six months (OR 2.58), along with higher MELD score, ascites, hepatic encephalopathy, and hyponatremia, independently increased the risk of 30-day readmission in patients with cirrhosis.

Q: What question did this study set out to answer?

The study aims to identify factors predicting 30-day hospital readmission in patients with cirrhosis.

NANoor AlbustaLahey Hospital and Medical Center AYAli YusufInternational Hospital of Bahrain HAHussain Nasser Saleh AlrahmaSalmaniya Medical Complex

Key Result

Prior hospitalization within six months (OR 2.58), along with higher MELD score, ascites, hepatic encephalopathy, and hyponatremia, independently increased the risk of 30-day readmission in patients with cirrhosis.

Key Points

The study aims to identify factors predicting 30-day hospital readmission in patients with cirrhosis.
Conducted a retrospective cohort study
Included adult patients with cirrhosis admitted to a tertiary care center
Collected demographic, clinical, and laboratory data
Analyzed data using multivariate logistic regression
The 30-day readmission rate was 27.3%
Higher MELD score correlated with increased readmission risk (OR 1.08 per point increase)
Ascites and hepatic encephalopathy were identified as significant predictors with ORs of 2.14 and 1.89, respectively
Hyponatremia was associated with an increased risk (OR 1.76)
Prior hospitalization within six months also increased the risk of readmission (OR 2.58)

Study Design

Type

Cohort (n=527)

Multicenter

Structured PICO

Population

527 adult patients with cirrhosis admitted to a tertiary care center in Bahrain, evaluated for predictors of 30-day hospital readmission.

Outcome

30-day hospital readmission, defined as any unplanned admission within 30 days of discharge from the index hospitalizationhard clinical

In patients with cirrhosis, 30-day readmission is common (27.3%) and is independently predicted by markers of disease severity including higher MELD score, ascites, hepatic encephalopathy, hyponatremia, and prior hospitalization.

Main Result

Odds Ratio: 2.58 (95% CI 1.65–4.04)

p-value: p=<0.001

Limitations

Retrospective design subject to missing data, selection bias, and unmeasured confounding.
Single tertiary care center in Bahrain, which may limit generalizability to other settings.
Readmissions to other hospitals outside the study center may not have been captured, potentially underestimating the true readmission rate.
Did not assess the preventability of readmissions or distinguish between liver-related and non-liver-related readmissions.
Specific interventions such as rifaximin use, lactulose dosing, and discharge planning quality were not systematically evaluated.
Longer-term outcomes beyond 30 days, including 90-day readmissions and mortality, were not examined.

Abstract

Introduction: Cirrhosis is associated with significant morbidity and frequent hospital readmissions due to recurrent complications. Thirty-day readmission is an important quality metric linked to increased healthcare costs and mortality. Identifying predictors of early readmission may help guide targeted interventions. Methods: We conducted a retrospective cohort study of adult patients (≥18 years) with cirrhosis admitted to a tertiary care center in Bahrain between January 1, 2023, and December 31, 2025. Demographic, clinical, and laboratory data were collected from electronic medical records. The primary outcome was 30-day hospital readmission. Multivariate logistic regression was used to identify independent predictors. Results: A total of 527 patients were included, with a mean age of 56.8 ± 13.2 years; 324 (61.5%) were male. The most common etiologies were metabolic dysfunction-associated steatotic liver disease (203 (38.5%)), alcohol-related liver disease (143 (27.1%)), and viral hepatitis (130 (24.7%)). Ascites was present in 329 patients (62.4%) and hepatic encephalopathy in 184 patients (34.9%). Hyponatremia (serum sodium < 130 mmol/L) occurred in 148 patients (28.1%), and prior hospitalization within six months occurred in 211 patients (40.0%). The mean Model for End-Stage Liver Disease (MELD) score was 16.7 ± 6.3. The 30-day readmission rate was 144 (27.3%). Independent predictors of readmission included a higher MELD score (odds ratio (OR) 1.08 per point increase, 95% confidence interval (CI) 1.04-1.12, p < 0.001), ascites (OR 2.14, 95% CI 1.38-3.31, p = 0.001), hepatic encephalopathy (OR 1.89, 95% CI 1.21-2.95, p = 0.005), hyponatremia (OR 1.76, 95% CI 1.12-2.77, p = 0.014), and prior hospitalization (OR 2.58, 95% CI 1.65-4.04, p < 0.001). Conclusion: Thirty-day readmission among patients with cirrhosis is common and is primarily driven by disease severity and complications. Higher MELD score, ascites, hepatic encephalopathy, hyponatremia, and prior hospitalization were independently associated with increased readmission risk. Identifying high-risk patients may allow implementation of targeted interventions, including optimization of medical management and early outpatient follow-up, to reduce readmission and improve outcomes.

اسأل الذكاء الاصطناعي

Bookmark

View Full Paper