Early hospital readmission in decompensated cirrhosis: Incidence, impact on mortality, and predictive factors

Betty P. Morales, Ramon Planas, Ramon Bartoli, Rosa M. Morillas, Margarita Sala, Eduard Cabré, Irma Casas, Helena Masnou

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Abstract

© 2017 Editrice Gastroenterologica Italiana S.r.l. 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.
Original languageEnglish
Pages (from-to)903-909
JournalDigestive and Liver Disease
Volume49
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Keywords

  • Decompensated cirrhosis
  • Hospital readmissions
  • Independent predictors
  • Mortality

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    Morales, B. P., Planas, R., Bartoli, R., Morillas, R. M., Sala, M., Cabré, E., Casas, I., & Masnou, H. (2017). Early hospital readmission in decompensated cirrhosis: Incidence, impact on mortality, and predictive factors. Digestive and Liver Disease, 49(8), 903-909. https://doi.org/10.1016/j.dld.2017.03.005