BACKGROUND/AIMS Alcoholic hepatitis (AH) can lead to sudden and severe hepatic decompensation necessitating recurrent hospitalizations. We evaluated the trends, predictors, and healthcare cost burden of AH-related readmissions in the USA. METHODS Utilizing the National Readmissions Database 2010-2014, we performed a retrospective longitudinal analysis to identify the index readmission with AH for up to 90 days after discharge. Annual trends of 30- and 90-day AH-related readmissions were calculated. Predictors of 30- and 90-day readmission were determined by multivariate logistic regression. Annual healthcare cost burden associated with AH-linked readmissions was estimated. RESULTS Of the 21,572 (unweighted: 50,769) AH-related hospitalizations, 4917 (22.8%) and 7890 (36.6%) were readmitted in 30 and 90 day, respectively, with rates that were statistically unchanged from 2010 to 2014. Predictors of 30-day readmissions included female gender, hepatitis C virus infection, cirrhosis, ascites, acute kidney injury, urinary tract infection, history of bariatric surgery, chronic pancreatitis, and high medical comorbidity index. Acute pancreatitis and palliative care consultation were associated with a lower risk of 30-day readmission. Predictors of 90-day readmission were similar to risk factors for 30-day readmission. From 2010 to 2014, the annual cost (and total hospitalization days) burden increased in 2014 to $164 million (22,244 days) and $321 million (42,772 days) for 30- and 90-day AH-related readmissions, respectively. CONCLUSION Despite relatively stable trends in AH-related readmission, the total LOS and cost has been rising. A target-directed approach with a focus on high-risk subpopulations may help understand the unique challenges associated with the rising cost of AH-related readmissions.

中文翻译：

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酒精性肝炎的再入院率和相关结果：全国队列研究。

背景/目的酒精性肝炎（AH）可能导致突然的和严重的肝代偿失调，需要再次住院治疗。我们评估了美国AH相关再入院的趋势，预测指标和医疗费用负担。方法利用美国国家再入院数据库2010-2014，进行回顾性纵向分析，以确定出院后长达90天的AH指数再入院。计算了与AH相关的30天和90天再入院的年度趋势。通过多因素logistic回归确定30天和90天再入院的预测指标。估计与AH相关的再入院相关的年度医疗保健费用负担。结果在21,572例（未加权：50,769例）与AH相关的住院治疗中，分别在30和90天内再次入院4917（22.8％）和7890（36.6％），从2010年到2014年，这一比率在统计学上没有变化。30天再入院的预测因素包括女性，丙型肝炎病毒感染，肝硬化，腹水，急性肾损伤，尿路感染，减肥手术史，慢性胰腺炎和高合并症指数。急性胰腺炎和姑息治疗咨询与30天再次入院的风险较低相关。90天再入院的预测因素与30天再入院的危险因素相似。从2010年到2014年，2014年与AH相关的30和90天与AH相关的再次住院的年度费用（和总住院天数）负担分别增加到1.64亿美元（22,244天）和3.21亿美元（42,772天）。结论尽管与AH相关的再入院趋势相对稳定，但总LOS和成本一直在上升。