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Hospital readmission rates remain high in patients with cirrhosis
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VIENNA — A majority of patients hospitalized with cirrhosis were readmitted to the hospital due to infection and other liver-related complications within 3 months of being discharged, according to a poster presented at the 2015 International Liver Congress.
Jasmohan S. Bajaj, MD, associate professor of gastroenterology, hepatology and nutrition at Virginia Commonwealth University and Hunter Holmes McGuire VA Medical Center, and colleagues analyzed data collected from the North American Consortium for the Study of End-stage Liver Disease of 578 patients hospitalized with cirrhosis. Researchers followed patients who were discharged for 3 months to determine any readmissions, transplantation and mortality. Logistic regression analyses were used to determine and analyze reasoning for readmission.
Jasmohan S. Bajaj
During follow-up, 77 patients died or entered hospice and 20 underwent transplantation. Therefore, 481 patients were included in the final analysis.
Overall, 50% of the patients were readmitted at least once during the follow-up period; 56% had one readmission, 28% had two readmissions and 16% had three or more readmissions.
Forty percent of readmissions were due to infections, 49% due to liver-related complications and 11% for other reasons, according to the research. Readmission rates were similar for patients admitted with infection and those without (50% vs. 51%; P = .8).
The researchers used the index hospitalization day of admission values and determined a high MELD score (P = .001), lactulose use (P = .05) and male gender (P = .05) predicted readmission. The index hospitalization discharge values determined MELD score (P = .002) and spontaneous bacterial peritonitis prophylaxis (P = .05) to be predictors of 3-month readmission on discharge.
“We found in a large multicenter study of hospitalized cirrhotic patients that 50% of them were re-hospitalized within 3 months of discharge, most often due to problems related to worse liver disease severity and use of antibiotics,” Bajaj told Healio.com/Hepatology. “We recommend that every effort be put in to reduce this huge health care burden by focusing on patients with advanced degrees of liver disease severity on discharge.” – by Melinda Stevens
Reference:
Bajaj JS, et al. Poster 0120. Presented at: International Liver Congress; April 22-26, 2015; Vienna.
Disclosure: The study was supported by an independent grant from Grifols Pharmaceuticals to the North American Consortium for the Study of End-stage Liver Disease.