Paracentesis in cirrhotics is associated with increased risk of 30-day readmission

Table 1 Index admission characteristics for adult patients with decompensated cirrhosis

	Overall		No readmission within 30 d		30-day readmission		P-value
	n = 59597		n = 41279		n = 18319
Age (mean, SE)	59.15	0.12	59.41	0.13	58.58	0.17	< 0.001
Age, yr							0.004
< 40	2636	4.42	1727	4.18	909	4.96
40-64	38865	65.21	26798	64.92	12067	65.88
≥ 65	18096	30.36	12754	30.90	5342	29.16
Gender							0.679
Male	36582	61.38	25302	61.30	11280	61.58
Female	23015	38.62	15976	38.70	7039	38.42
Type of insurance							< 0.001
Medicare	26282	44.18	18150	44.05	8132	44.48
Medicaid	12784	21.49	8424	20.44	4360	23.85
Private	11957	20.10	8383	20.34	3575	19.55
Other	8465	14.23	6250	15.17	2216	12.12
Income (Zip Code)							0.392
1-37999	18523	31.76	12722	31.49	5801	32.35
38000-47999	16491	28.27	11394	28.20	5097	28.43
48000-63999	13613	23.34	9542	23.62	4071	22.70
64000+	9702	16.63	6740	16.68	2962	16.52
AHRQ-Elixhauser Index							0.003
< 3	13981	23.46	9923	24.04	4058	22.15
≥ 3	45616	76.54	31356	75.96	14260	77.85
Hospital size							0.646
Small	6345	10.65	4435	10.75	1910	10.43
Medium	13725	23.03	9555	23.15	4169	22.76
Large	39527	66.32	27288	66.11	12239	66.81
Type of hospital							0.020
Urban non-teaching	22770	38.21	15896	38.51	6875	37.53
Urban teaching	30504	51.18	20879	50.58	9625	52.54
Rural	6322	10.61	4504	10.91	1819	9.93
Etiology of cirrhosis							< 0.001
Alcoholic	34242	57.45	24072	58.32	10170	55.52
Non-alcoholic	25356	42.55	17207	41.68	8149	44.48
In-hospital procedures
Paracentesis	29832	50.06	19914	48.24	9918	54.14	< 0.001
Features of liver decompensation
Esophageal varices	272	0.46	201	0.49	71	0.39	0.313
Portal hypertension	22074	37.04	15264	36.98	6810	37.17	0.794
Hepatorenal syndrome	2734	4.59	1817	4.40	917	5.00	0.055
Hepatocellular carcinoma	2274	3.82	1471	3.56	803	4.38	0.002
Index admission mortality1
None	59566	94.41	--	--	--	--
Mortality	3526	5.59	--	--	--	--
Calendar year mortality							< 0.001
None	53603	89.97	38960	94.42	14643	79.95
Mortality	5978	10.03	2304	5.58	3673	20.05
Length of stay (mean, SE)	5.69	0.08	5.66	0.10	5.77	0.10	0.345
Cost (mean, SE)	12488	363	12403	378	12680	421	0.391

¹Out of a total of 63092 patients as the index admission mortality exclusion was not applied.

Table 2 Multivariable logistic regression model for 30-d readmission

	OR (95%CI)		P-value
Age, yr			< 0.001
< 40	1.42	(1.22, 1.66)
40-64	1.19	(1.09, 1.30)
≥ 65	Reference
Type of insurance			< 0.001
Private	Reference
Medicare	1.13	(1.02, 1.26)
Medicaid	1.20	(1.08, 1.33)
Other	0.83	(0.75, 0.92)
AHRQ-elixhauser index			0.001
< 3	Reference
≥ 3	1.13	(1.05, 1.22)
Etiology of cirrhosis			< 0.001
Alcoholic	Reference
Non-alcoholic	1.16	(1.10, 1.23)
Paracentesis	1.28	(1.21, 1.36)	< 0.001
Hepatocellular Carcinoma	1.21	(1.05, 1.39)	0.010

Terms included in the model were determined through stepwise selection where all variables shown in Table 1 (the full logistic regression model) were eligible for inclusion.