Predictors of Three-month Hospital Readmissions and Mortality in Patients with Cirrhosis of Liver

Abstract

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.

Risk factors for hospital readmission among patients with cirrhosis and ascites in China: a retrospective observational study

“…Additionally, it has been hypothesized that lower serum albumin levels not only reflect liver synthetic dysfunction but also malnutrition and a more pronounced systemic inflammatory response, which are associated with poorer outcomes and increased health care utilization. The MELD-Na score has been identified as an independent risk factor for readmission in multiple studies; 11 – 13 , 15 , 21 , 28 , 29 this score reflects the severity of liver disease and the patient’s overall prognosis. The MELD-Na score is often used to prioritize candidates for liver transplantation, which inherently poses a greater risk of complications requiring readmission.…”

Rate of repeated hospitalization of patients with cirrhosis and its risk factors

“…V multivariantnej analýze boli faktormi 180-dňovej mortality ascites, fajčenie a MELD -Na skóre(11). Mortalita pacientov od prepustenia sa do 3 mesiacov pohybuje v literatúre od 16-18 %(12). Môžeme konštatovať, že celková mortalita pacientov s dekompenzáciou cirhózy, či už s nutnosťou rehospitalizácie alebo bez nej, je veľmi vysoká.…”