Background and objective Cirrhosis is the number one cause of non-cancer deaths among gastrointestinal diseases and is responsible for significant morbidity and healthcare utilisation. The objectives were to measure the 30-day readmissions rate following index hospitalisation, to determine the predictors of readmission, and to estimate the cost of 30-day readmission in patients with decompensated cirrhosis. Methods We performed a retrospective cohort study of patients with decompensated cirrhosis using 2014 Nationwide Readmission Database from January to November. Decompensated cirrhosis was identified based on the presence of at least one of the following: ascites, hepatic encephalopathy, variceal bleeding, spontaneous bacterial peritonitis and hepatorenal syndrome. We excluded patients less than 18 years of age, pregnant patients, patients with missing length of stay data, and those who died during the index admission. Results Among 57 305 unique patients with decompensated cirrhosis, the 30-day readmission rate was 23.2%. The top three predictors of 30-day readmission were leaving against medical advice (AMA), ascites and acute kidney injury, which increased the risk of readmission by 47%, 22% and 20%, respectively. Index admission for variceal bleeding was associated with a lower 30-day readmission rate by 18%. The estimated total cost associated with 30-day readmission in our study population was US$234.4 million. Conclusion In a nationwide population study, decompensated cirrhosis is associated with a 30-day readmission rate of 23%. Leaving AMA, ascites and acute kidney injury are positively associated with readmission. Targeted interventions and quality improvement efforts should be directed toward these potential risk factors to reduce readmissions. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data are deidentified participant data from HCUP (AHRQ).

中文翻译：

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失代偿期肝硬化患者 30 天再入院发生率和预测因素的全国分析

背景和目的 肝硬化是胃肠道疾病中非癌症死亡的第一大原因，并导致显着的发病率和医疗保健利用。目的是测量指数住院后的 30 天再入院率，确定再入院的预测因子，并估计失代偿期肝硬化患者 30 天再入院的成本。方法 我们使用 2014 年 1 月至 11 月的全国再入院数据库对失代偿期肝硬化患者进行了一项回顾性队列研究。失代偿期肝硬化是基于以下至少一项的存在来确定的：腹水、肝性脑病、静脉曲张出血、自发性细菌性腹膜炎和肝肾综合征。我们排除了 18 岁以下的患者、怀孕的患者、住院时间数据缺失的患者，以及在指数入院期间死亡的患者。结果 57 305 例失代偿期肝硬化患者中，30 天再入院率为 23.2%。30 天再入院的前三个预测因素是违反医疗建议 (AMA)、腹水和急性肾损伤，这使再入院的风险分别增加了 47%、22% 和 20%。静脉曲张出血指数入院与 30 天再入院率降低 18% 相关。在我们的研究人群中，与 30 天再入院相关的估计总成本为 2.344 亿美元。结论 在一项全国性人群研究中，失代偿期肝硬化与 23% 的 30 天再入院率相关。离开 AMA、腹水和急性肾损伤与再入院呈正相关。应针对这些潜在风险因素进行有针对性的干预和质量改进工作，以减少再入院。可根据合理要求提供数据。所有与研究相关的数据都包含在文章中或作为补充信息上传。数据是来自 HCUP (AHRQ) 的去识别参与者数据。