Rate of early hospital readmission amongst cirrhotic patients is high in Australia: experience from a single liver transplant centre.

Abstract

The 30-day hospital readmission rate in cirrhotic patients has been demonstrated to be up to 40% in international studies, but is not well studied in Australia. The aim of this study was to report on the rate and cause of 30-day hospital readmission from a single liver-transplant referral centre, including a cost analysis of readmissions. Retrospective study of consecutive cirrhotic patients admitted to a liver transplant centre in Victoria, Australia between 1st January 2019 and 31st December 2019. Cases were identified through International Classification of Diseases version 10 coding for cirrhosis and its complications. Baseline demographic data, liver-related complications and unrelated extra-hepatic comorbidities, laboratory values, and prognostic scores were collected from the electronic medical record. 179 patients (63% male, median age at index admission 59 years old) who were admitted a total of 427 times during the study period were included in the final analysis. 30-day hospital readmission rate was 46%, with the majority of readmissions due to fluid overload (29%), miscellaneous reasons (27%) and infection (20%). One-fifth of readmissions were considered preventable. History of variceal haemorrhage was found to be an independent predictor of 30-day hospital readmission. Annual cost of readmission is over 2.7 million dollars and median cost of hospital readmission was about $9,000. The 30-day hospital readmission rate of 46% is higher than previously reported and almost half due to either fluid overload or infection. This article is protected by copyright. All rights reserved.