Key result
Complications including hydrothorax, hepatorenal syndrome, and portal vein thrombosis, as well as MELD (AUC 0.928) and DF (AUC 0.927) scores, significantly predicted 3-month readmission and mortality.
Why the study?
What are the predictors of 3-month hospital readmission and mortality in patients with liver cirrhosis?
Cohort (n=232)
No
What are the predictors of 3-month hospital readmission and mortality in patients with liver cirrhosis?
MELD score, Maddrey's DF, and complications such as hydrothorax, hepatorenal syndrome, and portal vein thrombosis are strong predictors of 3-month readmission and mortality in patients with liver cirrhosis.
Provides first Indian data on 3-month readmission and mortality in cirrhosis; extends evidence to South Asian settings but leaves practice change open.
BACKGROUND: The rate of readmission to the hospital and mortality within 3 months is used as a quality measure for hospitalized patients with advanced liver disease; however, the topic has not been studied adequately under Indian context. MATERIALS AND METHODS: This study was a longitudinal study conducted from March 2017 to March 2018. Patients admitted with liver cirrhosis at inpatient hepatology service in Tertiary Health Care Centre, Mysore, India, were included for the study. A total of 232 patients were studied and their demographic, clinical, biochemical parameters along with readmission status and outcomes within 3 months of observation were recorded. The effect of these factors on readmission and mortality was studied through multivariate logistic regression. RESULTS: The risk of readmission within 3 months was significantly associated with the presence of hydrothorax, hepatorenal syndrome (HRS), and portal vein thrombosis (PVT). Maddrey's discriminant function (DF), model for end-stage liver disease (MELD) score, and the Child-Turcotte-Pugh (CTP) C grade also significantly increased the odds of readmission. The area under curve (AUC) for DF and MELD were 0.927 and 0.928, respectively. Both DF and MELD significantly increased the odds of mortality. CONCLUSION: The present study revealed that the parameters such as MELD and DF score and complications such as hydrothorax, HRS, and PVT are the most predictive indicators of cirrhosis complication to ascertain the rate of readmission and mortality within 3 months of patient discharge. HOW TO CITE THIS ARTICLE: . Predictors of Three-month Hospital Readmissions and Mortality in Patients with Cirrhosis of Liver. Euroasian J Hepato-Gastroenterol 2019;9(2):71-77.
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Manohar et al. (2017) conducted a cohort in Liver cirrhosis (n=232). Clinical and biochemical parameters (hydrothorax, HRS, PVT, MELD, DF, CTP) vs. Absence of complications or lower scores was evaluated on Hospital readmission and mortality within 3 months. Complications including hydrothorax, hepatorenal syndrome, and portal vein thrombosis, as well as MELD (AUC 0.928) and DF (AUC 0.927) scores, significantly predicted 3-month readmission and mortality.
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