Rates, Reasons, and Independent Predictors of Readmissions in Portal Venous Thrombosis Hospitalizations in the USA

Abstract

Background: Portal vein thrombosis (PVT), generally considered rare, is becoming increasingly recognized with advanced imaging. Limited data exist regarding readmissions in PVT and its burden on the overall healthcare cost. This study aimed to outline the burden of PVT readmissions and identify the modifiable predictors of readmissions. Methods:The National Readmission Database (NRD) was used to identify PVT admissions from 2016 to 2019. Using the patient demographic and hospital-specific variables within the NRD, we grouped patient encounters into two cohorts, 30-and 90-day readmission cohorts. We assessed comorbidities using the validated Elixhauser comorbidity index. We obtained inpatient mortality rates, mean length of hospital stay (LOS), total hospital cost (THC), and causes of readmissions in both 30-and 90-day readmission cohorts. Using a multivariate Cox regression analysis, we identified the independent predictors of 30-day readmissions. Results:We identified 17,971 unique index hospitalizations, of which 2,971 (16.5%) were readmitted within 30 days. The top five causes of readmissions in both 30-day and 90-day readmission cohorts were PVT, sepsis, hepatocellular cancer, liver failure, and alcoholic liver cirrhosis. The following independent predictors of 30-day readmission were identified: discharge against medical advice (AMA) (adjusted hazard ratio (aHR) 1.86; P = 0.002); renal failure (aHR 1.44, P = 0.014), metastatic cancer (aHR 1.31, P = 0.016), fluid and electrolyte disorders (aHR 1.20, P = 0.004), diabetes mellitus (aHR 1.31, P = 0.001) and alcohol abuse (aHR 1.31, P ≤ 0.001). Conclusion:The readmission rate identified in this study was higher than the national average and targeted interventions addressing these factors may help reduce the overall health care costs.

Readmission rates and outcomes in adults with and without COVID-19 following inpatient chemotherapy admission: A nationwide analysis

“…The NRD is a national database that captures patients' hospitalization, readmissions, and other relevant discharge histories from over 31 different states in the United States. The NRD is a product of the Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, and the Agency for Healthcare Research and Quality[ 9 ]. The database records over 40 International Classification of Diseases-10 (ICD-10) recognized diagnoses and 25 procedures[ 9 ].…”

“…The NRD is a product of the Healthcare Cost and Utilization Project (HCUP), State Inpatient Databases, and the Agency for Healthcare Research and Quality[ 9 ]. The database records over 40 International Classification of Diseases-10 (ICD-10) recognized diagnoses and 25 procedures[ 9 ]. It covers approximately 62.2% of the United States population and 60.8% of total hospitalizations in the country[ 15 ].…”

“…The COVID-19 pandemic has had a profound impact on various aspects of human life[ 6 ], with healthcare services and delivery being particularly affected[ 7 , 8 ]. The 30-day readmission rate serves as a crucial metric used by the Center for Medicare and Medicaid Services to evaluate hospitals and assess the quality of healthcare services[ 9 , 10 ]. In 2012, the Center for Medicare and Medicaid Services introduced the Hospital Readmission Reduction Program to enhance healthcare quality and reduce costs[ 11 ].…”

Eliminating COVID‐19 as the immediate culprit for igniting pancreatitis

“…According to available data, a study has shown that around 0.5% of individuals diagnosed with COVID‐19 have readmission within 30 days due to primary gastrointestinal reasons. The leading factors contributing to these readmissions are gastrointestinal bleeding, intestinal obstruction, acute diverticulitis, acute pancreatitis (AP), and acute cholecystitis 7 . The gut microbiota is crucial in maintaining human health since it is intricately linked to energy metabolism and immunological control.…”

“…The leading factors contributing to these readmissions are gastrointestinal bleeding, intestinal obstruction, acute diverticulitis, acute pancreatitis (AP), and acute cholecystitis. 7 The gut microbiota is crucial in maintaining human health since it is intricately linked to energy metabolism and immunological control. The gut microbiota is a critical intermediary for transmitting intestinal illnesses to extraintestinal organs.…”