Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2021; 13(12): 2128-2136
Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.2128
Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions
Asim Kichloo, Zain El-Amir, Dushyant Singh Dahiya, Farah Wani, Jagmeet Singh, Dhanshree Solanki, Ehizogie Edigin, Precious Eseaton, Asad Mehboob, Hafeez Shaka
Asim Kichloo, Zain El-Amir, Dushyant Singh Dahiya, Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, United States
Asim Kichloo, Farah Wani, Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
Jagmeet Singh, Department of Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA 18840, United States
Dhanshree Solanki, Department of Internal Medicine, Rutgers University, New Brunswick, NJ 07103, United States
Ehizogie Edigin, Hafeez Shaka, Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL 60612, United States
Precious Eseaton, Department of Internal Medicine, University of Benin School of Medicine, Edo 300213, Nigeria
Asad Mehboob, Division of Gastroenterology, Department of Internal Medicine, Covenant Healthcare, Saginaw, MI 48602, United States
Author contributions: Kichloo A, El-Amir Z and Dahiya DS contributed to conception and design; Singh J, Solanki D and Mehboob A gave administrative support; Shaka H and Edigin E contributed to provision, collection, and assembly of data; Kichloo A, El-Amir Z, Dahiya DS and Shaka H revised key components of manuscript; All authors reviewed literature, drafted the manuscript, made final approval of manuscript and agree to be accountable for all aspects of the work.
Institutional review board statement: As the National Readmission Database lacks patient and hospital-specific identifiers, this study was exempt from the Institutional Review Board (IRB) approval as per guidelines put forth by our institutional IRB for research on database studies.
Conflict-of-interest statement: The authors have no financial relationships or conflict-of-interests to disclose.
Data sharing statement: The NIS database can be accessed at https://www.hcup-us.ahrq.gov.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dushyant Singh Dahiya, MD, Doctor, Department of Internal Medicine, Central Michigan University College of Medicine, 1000 Houghton Ave, Saginaw, MI 48602, United States. dush.dahiya@gmail.com
Received: June 29, 2021
Peer-review started: June 29, 2021
First decision: August 18, 2021
Revised: August 24, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: December 27, 2021
ARTICLE HIGHLIGHTS
Research background

Readmissions of alcoholic liver cirrhosis (ALC) are associated with poor outcomes.

Research motivation

There is paucity of data on the trends of 30-d readmissions of ALC in the United States despite it being a significant healthcare burden.

Research objectives

The primary objective of this study was to identify and assess trends of 30-d readmissions of ALC in the United States over an eight-year period.

Research methods

This retrospective interrupted trend study used the National Readmissions Database to identify all 30-d readmissions of ALC. Multivariate regression analysis was used to calculate the trend for risk-adjusted odds of 30-d all-cause ALC readmissions, ALC specific readmission rate, ALC readmission proportion, mortality, mean length of stay (LOS) and mean total hospital cost (THC).

Research results

There was a trend towards increasing total 30-d readmissions of ALC, risk-adjusted 30-d all-cause ALC readmission, ALC specific readmission rate, and ALC readmission proportion. However, inpatient mortality declined from 10.5% in 2010 to 8.2% in 2018. The total days of hospital stay attributable to 30-d readmissions of ALC increased by 119.2% while the total attributable hospital costs increased by 149% by the end of 2018.

Research conclusions

The total number of 30-d readmissions of ALC increased; however, inpatient mortality declined. There was a trend towards increasing LOS and THC for these readmissions.

Research perspectives

Future studies are needed to investigate the treatment aspects of ALC in an inpatient setting. Additionally, the impact of early enrollment of patients into alcohol rehabilitation programs, patient education, regular outpatient follow-up and early effective alcohol use disorder treatments in the outpatient setting to prevent readmissions of ALC in is yet to be determined.