Key result
Among 58,954 patients admitted with cirrhosis-related complications, 25% were readmitted within 90 days, with male sex, age <60, and ≥3 comorbidities identified as independent predictors.
Why the study?
The burden of cirrhosis on the healthcare system is substantial and growing, warranting estimates of readmission rates, hospitalization costs, and risk factors for 90-day readmission.
Observational (n=58,954)
Yes
A quarter of patients admitted with cirrhosis-related complications are readmitted within 90 days, highlighting a significant economic burden and the need for targeted interventions.
High 90-day cirrhosis readmission burden supports targeted discharge planning; retrospective data leaves open prospective validation of predictors.
BACKGROUND: The burden of cirrhosis on the healthcare system is substantial and growing. Our objectives were to estimate the readmission rates and hospitalization costs as well as to identify risk factors for 90-day readmission in patients with cirrhosis. METHODS: We conducted a weighted analysis of the 2014 Nationwide Readmission Database to identify adult patients with cirrhosis-related complications in the United States and assessed readmission rates at 30, 60 and 90 days post-index hospitalization. Predictors of 90-day readmissions were identified using weighted regression models adjusting for patient and hospital characteristics; the national estimate of hospitalization costs was also calculated. RESULTS: Of the 58 954 patients admitted with cirrhosis-related complications in 2014, 14 910 (25%) were readmitted within 90 days because of cirrhosis-related complications. The main causes of readmission were ascites (56%), hepatic encephalopathy (47%) and bleeding oesophageal varices (9%). Independent predictors of 90-day readmissions were male sex (adjusted OR [aOR]: 1.08, 95% CI, 1.04-1.13), age <60 (aOR: 1.27, 95% CI, 1.22-1.32), privately insured (aOR: 0.74, 95% CI, 0.70-0.77), having ≥3 comorbid conditions (aOR: 1.27, 95% CI, 1.14-1.42) and being discharged against medical advice (aOR: 1.41, 95% CI, 1.25-1.59). The weighted cumulative national cost estimate of the index admission was $1.8 billion, compared to $0.5 billion for readmission. CONCLUSIONS: A quarter of patients admitted with cirrhosis-related complications were readmitted within 90 days, representing a significant economic burden related to readmission of this population. Interventions and resource allocations to reduce readmission rates among cirrhotic patients is critical.
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Shaheen et al. (2019) conducted an observational in Cirrhosis-related complications (n=58,954). Patient and hospital characteristics (e.g., male sex, age <60, comorbidities) vs. Reference groups was evaluated on 90-day readmission because of cirrhosis-related complications. Among 58,954 patients admitted with cirrhosis-related complications, 25% were readmitted within 90 days, with male sex, age <60, and ≥3 comorbidities identified as independent predictors.
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