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Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions
Shan Wang1,2, Lin Zhang1, Jin Li3
1Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China.
Insights
Cirrhosis patients with hepatic encephalopathy, ascites, or spontaneous bacterial peritonitis face higher readmission risks. Identifying these factors can help reduce hospitalizations and costs for liver disease patients in China.
Area of Science:
- Hepatology
- Internal Medicine
- Public Health
Background:
- Liver cirrhosis affects millions globally, posing significant health and economic burdens.
- In China, cirrhosis leads to severe complications, prolonged hospital stays, and increased healthcare costs.
- Predicting and preventing patient readmission is crucial for managing cirrhosis effectively.
Purpose of the Study:
- To identify key predictors of 30- and 90-day readmission in adult cirrhosis patients in China.
- To analyze factors influencing the length of initial hospitalization for cirrhosis patients.
- To inform strategies for reducing healthcare utilization among cirrhosis patients.
Main Methods:
- Retrospective study of 1,285 adult cirrhosis patients admitted between January 2009 and December 2022.
- Data collected included sociodemographic, clinical, and hospitalization characteristics.
- Logistic and multiple linear regression analyses were used to identify readmission predictors and factors affecting hospitalization length.
Main Results:
- 5.6% and 12.0% of patients were readmitted within 30 and 90 days, respectively.
- Readmitted patients had higher rates of ascites, spontaneous bacterial peritonitis, and elevated Child-Pugh-Turcotte scores.
- Hepatic encephalopathy, spontaneous bacterial peritonitis, diabetes, and ascites predicted 30- and 90-day readmissions.
Conclusions:
- Hepatic encephalopathy, ascites, and spontaneous bacterial peritonitis are significant risk factors for cirrhosis patient rehospitalization.
- Early identification and management of these complications may reduce readmission rates.
- Findings highlight the need for targeted interventions to improve outcomes for cirrhosis patients in China.
Introduction:
Liver disease remains a significant global health concern. In China, the number of patients with liver cirrhosis is estimated to reach 7 million. In addition to the high risk of death, cirrhosis leads to several severe complications. Patients with cirrhosis have significantly longer hospital stays and higher total hospital costs than those without cirrhosis. We aimed to investigate the predictors of readmission among patients with cirrhosis in China.
Materials And Methods:
We conducted a retrospective study to evaluate adult patients with cirrhosis. Data on various sociodemographic, clinical, and hospitalization characteristics were collected. We defined the primary endpoint as the first liver-related readmission occurring within 30-90 days of initial hospitalization. Adult patients with cirrhosis admitted to our hospital between January 2009 and December 2022 were included. Differences between groups were analyzed using Student's t-test and chi-square test. Logistic and multiple linear regression analyses were performed to identify predictors associated with readmission and the length of the first hospitalization.
Results:
In total, 1,285 patients were diagnosed with cirrhosis. Among these patients, 767 (59.7%) were males, and the mean age was 58.9 ± 12.3 years. Seventy-two (5.6%) and 154 (12.0%) patients were readmitted within 30 and 90 days, respectively. Compared with those who were not readmitted, patients readmitted at 30-day and 90-day had a higher proportion of males, ascites, spontaneous bacterial peritonitis, electrolyte abnormalities, higher Child-Pugh-Turcotte scores, longer initial hospital stays, and higher initial hospitalization costs. Logistic regression analysis indicated that hepatic encephalopathy, spontaneous bacterial peritonitis, diabetes, and ascites were predictors of 30- and 90-day readmission. Hypertension and spontaneous bacterial peritonitis were significant predictors of the length of the first hospitalization.
Conclusion:
Patients with cirrhosis presenting with hepatic encephalopathy, ascites, and spontaneous bacterial peritonitis may have a higher risk of rehospitalization.
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