Tropical Medicine Department, Mansoura University, Mansoura, Egypt.
Damietta Cardiology and Gastroenterology Center, Damietta, Egypt.
Eur J Med Res. 2023 May 12;28(1):168. doi: 10.1186/s40001-023-01126-2.
There is lack of 30-day hospital readmission prediction score in patients with liver cirrhosis and SBP. The aim of this study is to recognize factors capable of predicting 30-day readmission and to develop a readmission risk score in patients with SBP.
This study prospectively examined the 30-day hospital readmission for patients previously discharged with a diagnosis of SBP. Based on index hospitalization variables, a multivariable logistic regression model was implemented to recognize predictors of patient hospital readmission within 30 days. Consequently, Mousa readmission risk score was established to predict 30-day hospital readmission.
Of 475 patients hospitalized with SBP, 400 patients were included in this study. The 30-day readmission rate was 26.5%, with 16.03% of patients readmitted with SBP. Age ≥ 60, MELD > 15, serum bilirubin > 1.5 mg/dL, creatinine > 1.2 mg/dL, INR > 1.4, albumin < 2.5 g/dL, platelets count ≤ 74 (10/dL) were found to be independent predictors of 30-day readmission. Incorporating these predictors, Mousa readmission score was established to predict 30-day patient readmissions. ROC curve analysis demonstrated that at a cutoff value ≥ 4, Mousa score had optimum discriminative power for predicting the readmission in SBP with sensitivity 90.6% and specificity 92.9%. However, at cutoff value ≥ 6 the sensitivity and specificity were 77.4% and 99.7%, respectively, while a cutoff value ≥ 2 had sensitivity of 99.1% and specificity of 31.6%.
The 30-day readmission rate of SBP was 25.6%. With the suggested simple risk assessment Mousa score, patients at high risk for early readmission can be easily identified so as to possibly prevent poorer outcomes.
肝硬化伴自发性细菌性腹膜炎（SBP）患者缺乏 30 天住院再入院预测评分。本研究旨在识别能够预测 30 天再入院的因素，并为 SBP 患者开发再入院风险评分。
本研究前瞻性检查了既往诊断为 SBP 出院患者的 30 天住院再入院情况。基于入院期间的变量，采用多变量逻辑回归模型识别患者 30 天内住院再入院的预测因素。随后，建立了 Mousa 再入院风险评分来预测 30 天内的医院再入院。
在 475 例因 SBP 住院的患者中，有 400 例患者纳入本研究。30 天再入院率为 26.5%，其中 16.03%的患者因 SBP 再次入院。年龄≥60 岁、MELD＞15、血清胆红素＞1.5mg/dL、肌酐＞1.2mg/dL、INR＞1.4、白蛋白＜2.5g/dL、血小板计数≤74（10/dL）是 30 天再入院的独立预测因素。纳入这些预测因素后，建立了 Mousa 再入院评分来预测 30 天患者再入院。ROC 曲线分析表明，在截断值≥4 时，Mousa 评分对预测 SBP 再入院具有最佳判别能力，敏感性为 90.6%，特异性为 92.9%。然而，在截断值≥6 时，敏感性和特异性分别为 77.4%和 99.7%，而截断值≥2 时，敏感性为 99.1%，特异性为 31.6%。
SBP 的 30 天再入院率为 25.6%。通过建议的简单风险评估 Mousa 评分，可以很容易地识别出早期再入院风险较高的患者，从而可能预防较差的结局。
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