Patel Harish, Balar Bhavna, Irigela Maheswara, Vootla Vamshidhar, Chandrala Chaitanya, Hashmi Hafiz, Abdulsamad Molham, Makker Jasbir
Department of Medicine, BronxCare Health System, 1650 Selwyn Ave., Bronx, NY 10457, USA.
Gastroenterology Res. 2020 Feb;13(1):11-18. doi: 10.14740/gr1227. Epub 2020 Feb 1.
There are very limited data available on 30-day readmissions for ethnic minority patients with cirrhosis. The aim of the study was to identify the risk factors for 30-day readmission in ethnic minority patients admitted for cirrhosis.
We did a retrospective review of 1,373 electronic medical records of patients with cirrhosis admitted from 2009 to 2011. Several parameters including alcohol use history, discharge location and cirrhosis severity scores - model for end-stage liver disease (MELD) score and Child-Pugh-Turcotte (CPT) at first admission were assessed. Statistical analysis was done using Chi-square test and -test for categorical and continuous variables, respectively.
There were 79 patients in the readmission group (63% male, 54% Hispanics and 22% African Americans) and 104 in the no readmission group (62% male, 58% Hispanics and 24% African Americans). History of alcohol use within a month prior to admission (55% vs. 33%, P = 0.002), platelet count at discharge (89,000 vs. 124,000, P = 0.003), and discharge with more than seven medications per day (7.3 vs. 5.2, P = 0.005) were identified as risk factors for readmissions by multivariate analysis.
Platelet count, active alcohol use and more than seven medications at discharge are predictors of readmission. These parameters can guide future interventions to reduce readmission rate and health care costs related to cirrhosis readmissions.
关于肝硬化少数民族患者30天再入院的数据非常有限。本研究的目的是确定因肝硬化入院的少数民族患者30天再入院的风险因素。
我们对2009年至2011年收治的1373例肝硬化患者的电子病历进行了回顾性研究。评估了几个参数,包括饮酒史、出院地点和肝硬化严重程度评分——首次入院时的终末期肝病模型(MELD)评分和Child-Pugh-Turcotte(CPT)评分。分别使用卡方检验和t检验对分类变量和连续变量进行统计分析。
再入院组有79例患者(63%为男性,54%为西班牙裔,22%为非裔美国人),未再入院组有104例患者(62%为男性,58%为西班牙裔,24%为非裔美国人)。多因素分析确定入院前一个月内的饮酒史(55%对33%,P = 0.002)、出院时的血小板计数(89,000对124,000,P = 0.003)以及每天出院带药超过7种(7.3对5.2,P = 0.005)为再入院的风险因素。
血小板计数、近期饮酒以及出院带药超过7种是再入院的预测因素。这些参数可指导未来的干预措施,以降低再入院率和与肝硬化再入院相关的医疗费用。