Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis

Area of Science:

• Hepatology
• Internal Medicine
• Public Health

Background:

• Hospital readmissions are a significant concern for patients with cirrhosis.
• Understanding the preventability of these readmissions is crucial for improving patient outcomes and reducing healthcare costs.

Purpose of the Study:

• To determine the incidence, causes, and risk factors associated with preventable hospital readmissions in patients with cirrhosis.

Main Methods:

• A prospective cohort study was conducted with 654 cirrhosis patients over a 6-year period.
• Readmission preventability was adjudicated by three independent reviewers.
• Multinomial logistic regression identified factors associated with preventable readmissions.

Main Results:

• 38% of patients were readmitted within 30 days, with 12% deemed preventable.
• Common causes included hepatic encephalopathy, gastrointestinal bleeding, acute kidney injury, and ascites.
• Preventable readmissions were linked to racial/ethnic minority status, nonmarried status, and recent prior admissions.

Conclusions:

• While most cirrhosis readmissions are not preventable, those that are often stem from issues in managing ascites and hepatic encephalopathy.
• Interventions targeting social determinants of health and improving care coordination may reduce preventable readmissions in this population.