Thirty-Day Readmission after Esophageal Variceal Hemorrhage and its Impact on Outcomes in the United States

Mohammad Bilal, Marwan S. Abougergi, Obada Tayyem, Sreeram Parupudi, Don C. Rockey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Aims:The authors sought to determine the 30-day readmission rate of patients with esophageal variceal hemorrhage (EVH) and its impact on mortality, morbidity, and health care utilization.Background:EVH is a common complication of cirrhosis and leads to substantial morbidity and mortality.Study:The 2014 National Readmission Database was used to examine adult patients with urgent/emergent admissions and a principal diagnosis of EVH. The primary outcome was 30-day readmission. Secondary outcomes were in-hospital and 30-day mortality rate, most common reasons for readmission, readmission mortality rate, morbidity, and resource utilization. Independent risk factors for readmission were identified using multivariate regression analysis.Results:A total of 2003 patients with EVH were included. The mean age was 57 years and 29% of patients were female individuals. The all-cause 30-day readmission rate was 16.6%. EVH was the cause of readmission in only 5% of readmissions. Independent predictors of readmission were age and insurance type. The in-hospital and 30-day mortality rate for index admissions were 7.3% and 8.2%, respectively. For readmitted patients, the mortality rate was 3.9%. Although morbidity was lower during readmissions (prolonged mechanical ventilation: 0.4% vs. 3.5%, P<0.01 and shock: 1.8% vs. 9.9%, P<0.01), the cumulative additional length of stay was substantial at 2054 days with additional total hospitalization charges of US$20 million.Conclusions:The all-cause 30-day readmission rate after EVH is 16.6%, with most patients being readmitted for diagnoses unrelated to EVH. Readmission was associated with a substantial increase in in-hospital mortality and resource utilization. Risk factors for readmission were identified, which can potentially be used to decrease readmission rates.

Original languageEnglish (US)
Pages (from-to)477-483
Number of pages7
JournalJournal of clinical gastroenterology
Volume54
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • 30-day readmission
  • cirrhosis
  • esophageal varices
  • gastrointestinal bleeding
  • treatment outcomes
  • variceal bleeding

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Thirty-Day Readmission after Esophageal Variceal Hemorrhage and its Impact on Outcomes in the United States'. Together they form a unique fingerprint.

Cite this