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01-04-2020 | Bariatric Surgery | Original Article

Readmission Rates and Associated Outcomes for Alcoholic Hepatitis: A Nationwide Cohort Study

Authors: Adeyinka C. Adejumo, George Cholankeril, Umair Iqbal, Eric R. Yoo, Brian C. Boursiquot, Waldo C. Concepcion, Donghee Kim, Aijaz Ahmed

Published in: Digestive Diseases and Sciences | Issue 4/2020

Abstract

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.

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Title: Readmission Rates and Associated Outcomes for Alcoholic Hepatitis: A Nationwide Cohort Study
Authors: Adeyinka C. Adejumo
George Cholankeril
Umair Iqbal
Eric R. Yoo
Brian C. Boursiquot
Waldo C. Concepcion
Donghee Kim
Aijaz Ahmed
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Bariatric Surgery
Chronic Pancreatitis
Bariatric Surgery
Acute Pancreatitis
Hepatitis
Hepatitis C
Published in: Digestive Diseases and Sciences / Issue 4/2020
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-019-05759-4

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