Dai Jingyi, Zhao Jun, Du Yingrong, McNeil Edward B, Chongsuvivatwong Virasakdi
Department of Liver Diseases, The Third People's Hospital of Kunming City, Kunming, Yunnan, People's Republic of China.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Ther Clin Risk Manag. 2019 Aug 8;15:979-989. doi: 10.2147/TCRM.S203883. eCollection 2019.
Hospital readmissions of patients with cirrhosis is a current problem in China. This study aims to estimate the readmission rate at one year after discharge and to identify associated risk factors of hospital readmission.
Between January 2012 and December 2015, 3,402 patients admitted with cirrhosis were included in the study. The primary outcome was one-year inpatient readmission. Principal components analysis was conducted on the laboratory test indicators to reduce the number of dimensions. Univariate and multivariate analyses were performed using clinical and demographic data to identify independent associated factors of readmission within one year. The odds ratio (OR) and 95% confidence interval were used to assess the strength of association for each factor.
Two dimensions, namely "liver function" and "renal function", were revealed. Patients with a longer length of stay in the index admission (OR: 1.03; 95% CI: 1.03-1.04) and a higher dimension score of liver function (OR: 1.09; 95% CI: 1.05-1.13) were more likely to be readmitted within one-year. Older patients had a significantly higher odds of one-year readmission than younger patients (OR: 1.61; 95% CI: 1.22-2.11), patients who were married had a higher odds than those who were single (OR: 1.62; 95% CI: 1.12-2.36), and patients with hepatitis C virus were more likely to be readmitted within one year than patients with hepatitis B virus (OR: 1.51; 95% CI: 1.19-1.91).
Biomarkers and sociodemographic factors can identify patients at high risk for readmission within one year. Our data indicates the need to emphasize proper liver care to older patients who have been hospitalized for a long time.
肝硬化患者的医院再入院是中国当前面临的一个问题。本研究旨在估计出院后一年的再入院率，并确定医院再入院的相关危险因素。
2012年1月至2015年12月期间，3402例肝硬化住院患者纳入本研究。主要结局是一年期住院再入院。对实验室检查指标进行主成分分析以减少维度数量。使用临床和人口统计学数据进行单因素和多因素分析，以确定一年内再入院的独立相关因素。比值比（OR）和95%置信区间用于评估各因素的关联强度。
揭示了两个维度，即“肝功能”和“肾功能”。首次入院住院时间较长的患者（OR：1.03；95%CI：1.03 - 1.04）以及肝功能维度评分较高的患者（OR：1.09；95%CI：1.05 - 1.13）在一年内更有可能再次入院。老年患者一年期再入院的几率显著高于年轻患者（OR：1.61；95%CI：1.22 - 2.11），已婚患者的几率高于单身患者（OR：1.62；95%CI：1.12 - 2.36），丙型肝炎病毒患者一年内再次入院的可能性高于乙型肝炎病毒患者（OR：1.51；95%CI：1.19 - 1.91）。
生物标志物和社会人口学因素可识别一年内再入院风险较高的患者。我们的数据表明需要对长期住院的老年患者强调适当的肝脏护理。
