Betty P Morales1, Ramon Planas2, Ramon Bartoli3, Rosa M Morillas2, Margarita Sala2, Eduard Cabré2, Irma Casas4, Helena Masnou5. 1. Hospital Universitari Germans Trias i Pujol, Liver Unit, Gastroenterology, Departament of Medicine, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain. Electronic address: betty.pao82@hotmail.com. 2. Hospital Universitari Germans Trias i Pujol, Liver Unit, Gastroenterology, Departament of Medicine, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERHED, Barcelona, Spain. 3. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERHED, Barcelona, Spain; Fundació Germans Trias i Pujol, Gastroenterology, Badalona, Spain. 4. Hospital Universitari Germans Trias i Pujol, Preventive Medicine and Epidemiology Department, Autonomous University of Barcelona, Badalona, Barcelona, Spain. 5. Hospital Universitari Germans Trias i Pujol, Liver Unit, Gastroenterology, Departament of Medicine, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
Abstract
BACKGROUND & AIMS: The early hospital readmission of patients with decompensated cirrhosis is a current problem. A study is presented on the incidence, the impact on mortality, and the predictive factors of early hospital readmission. PATIENTS AND METHODS: On the study included 112 cirrhotic patients, discharged after some decompensation between January 2013 and May 2014. Multivariate analyses were performed to identify predictors of early readmission and mortality. RESULTS: The early readmission rate was 29.5%. The predictive factors were male gender (OR: 2.81; 95% CI: 1.07-7.35), Model for End-Stage Liver Disease-sodium score ≥15 (OR: 3.79; 95% CI 1.48-9.64), and Charlson index ≥7 (OR: 4.34, 95% CI 1.65-11.4). This model enabled patients to be classified into low or high risk of early readmissions (13.6% vs. 52.2%). The mortality rate was significantly higher among patients with early readmission (73% vs. 35%) (p<.0001). After adjusting for the Model for End-Stage Liver Disease-sodium score, Charlson index, dependence in activities of daily living, educational status, and number of medications on discharge, the early readmission was independently associated with mortality. CONCLUSIONS: Early hospital readmission is common, and is independently associated with mortality. Male gender, MELD-Na ≥15, and Charlson index ≥7 are predictors of early readmission. These results could be used to develop future strategies to reduce early readmission.
BACKGROUND & AIMS: The early hospital readmission of patients with decompensated cirrhosis is a current problem. A study is presented on the incidence, the impact on mortality, and the predictive factors of early hospital readmission. PATIENTS AND METHODS: On the study included 112 cirrhotic patients, discharged after some decompensation between January 2013 and May 2014. Multivariate analyses were performed to identify predictors of early readmission and mortality. RESULTS: The early readmission rate was 29.5%. The predictive factors were male gender (OR: 2.81; 95% CI: 1.07-7.35), Model for End-Stage Liver Disease-sodium score ≥15 (OR: 3.79; 95% CI 1.48-9.64), and Charlson index ≥7 (OR: 4.34, 95% CI 1.65-11.4). This model enabled patients to be classified into low or high risk of early readmissions (13.6% vs. 52.2%). The mortality rate was significantly higher among patients with early readmission (73% vs. 35%) (p<.0001). After adjusting for the Model for End-Stage Liver Disease-sodium score, Charlson index, dependence in activities of daily living, educational status, and number of medications on discharge, the early readmission was independently associated with mortality. CONCLUSIONS: Early hospital readmission is common, and is independently associated with mortality. Male gender, MELD-Na ≥15, and Charlson index ≥7 are predictors of early readmission. These results could be used to develop future strategies to reduce early readmission.
Authors: Jejo D Koola; Sam B Ho; Aize Cao; Guanhua Chen; Amy M Perkins; Sharon E Davis; Michael E Matheny Journal: Dig Dis Sci Date: 2019-09-17 Impact factor: 3.199
Authors: M Müller; J C Schefold; A B Leichtle; D Srivastava; G Lindner; A K Exadaktylos; C A Pfortmueller Journal: Med Klin Intensivmed Notfmed Date: 2018-08-21 Impact factor: 0.840
Authors: Sushil Kumar Garg; Hemant Goyal; Itegbemie Obaitan; Pir Ahmad Shah; Shashank Sarvepalli; Loretta Lynn Jophlin; Dupinder Singh; Sumeet Asrani; Patrick S Kamath; Michael D Leise Journal: Ann Transl Med Date: 2021-07
Authors: Colin Pawlowski; A J Venkatakrishnan; Eshwan Ramudu; Christian Kirkup; Arjun Puranik; Nikhil Kayal; Gabriela Berner; Akash Anand; Rakesh Barve; John C O'Horo; Andrew D Badley; Venky Soundararajan Journal: EClinicalMedicine Date: 2021-03-23