Chronic liver disease is associated with greater risk of hospital readmission in patients with heart failure: a nationwide database study in the US

Aims: There is limited evidence regarding the association between chronic liver disease (CLD) and the risk of readmission in patients with heart failure (HF). Methods and results: We utilized data from the 2019 Nationwide Readmissions Database (NRD). An index hospitalization was defined as a hospitalization for HF among patients aged ≥18 years with an alive discharge. We categorized patients into two groups, with and without CLD, and compared 30-day and 90-day all-cause and HF-specific readmission. Multiple logistic regression analyses were used to estimate the association between CLD and readmissions in HF patients, adjusting for demographic and clinical characteristics. We also evaluated the association between specific CLD subtypes [i.e. hepatitis B (HBV), hepatitis C (HCV), alcoholic liver disease (ALD), and metabolic dysfunction-associated steatotic liver disease (MASLD)] and the risk of readmission. The study included 2 370 469 index HF hospitalizations for the 30-day analysis and 2 090 370 for the 90-day analysis. CLD patients had higher 30-day all-cause [adjusted odds ratio (aOR) 1.20 (1.18-1.23)] and HF-specific [aOR 1.16 (1.14-1.19)] readmission rates compared with those without CLD. Similar findings were observed for 90-day all-cause [aOR 1.19 (1.17-1.21)] and HF-specific [aOR 1.13 (1.11-1.16)] readmissions. Results were consistent when comparing patients with and without HBV, HCV, and ALD, with no meaningful differences observed between those with and without MASLD. Conclusion: Compared with HF patients without CLD, those with CLD had a higher risk of 30- and 90-day readmissions, underscoring the importance of accounting for CLD in the risk assessment and clinical decision-making for HF patients.