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Atla PR, Sheikh MY, Gill F, et al. Predictors of hospital re-admissions among Hispanics with hepatitis C-related cirrhosis. Ann Gastroenterol. 2016;29(4):515-520doi: 10.20524/aog.2016.0072.
Atla, P. R., Sheikh, M. Y., Gill, F., Kundu, R., & Choudhury, J. (2016). Predictors of hospital re-admissions among Hispanics with hepatitis C-related cirrhosis. Annals of gastroenterology, 29(4), 515-520. https://doi.org/10.20524/aog.2016.0072
Atla, Pradeep R, et al. "Predictors of hospital re-admissions among Hispanics with hepatitis C-related cirrhosis." Annals of gastroenterology vol. 29,4 (2016): 515-520. doi: https://doi.org/10.20524/aog.2016.0072
Atla PR, Sheikh MY, Gill F, Kundu R, Choudhury J. Predictors of hospital re-admissions among Hispanics with hepatitis C-related cirrhosis. Ann Gastroenterol. 2016 Oct-Dec;29(4):515-520. doi: 10.20524/aog.2016.0072. Epub 2016 Jul 21. PMID: 27708520; PMCID: PMC5049561.
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Ann Gastroenterol. 2016 Oct-Dec;29(4):515-520. doi: 10.20524/aog.2016.0072. Epub 2016 Jul 21.

Predictors of hospital re-admissions among Hispanics with hepatitis C-related cirrhosis.

Annals of gastroenterology

Pradeep R Atla, Muhammad Y Sheikh, Firdose Gill, Rabindra Kundu, Jayanta Choudhury

Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, University of California San Francisco, Fresno MEP (Pradeep R. Atla, Muhammad Y. Sheikh, Rabindra Kundu, Jayanta Choudhury), Fresno, California, USA.
  2. Department of Medicine, Kaiser Permanente Fresno Medical Center (Firdose Gill), Fresno, California, USA.

PMID: 27708520 PMCID: PMC5049561 DOI: 10.20524/aog.2016.0072

Abstract

BACKGROUND: Hospital re-admissions in decompensated cirrhosis are associated with worse patient outcomes. Hispanics have a disproportionately high prevalence of hepatitis C virus (HCV)-related morbidity and mortality. The goal of this study was to evaluate the factors affecting re-admission rates among Hispanics with HCV-related cirrhosis.

METHODS: A total of 292 consecutive HCV-related cirrhosis admissions (Hispanics 189, non-Hispanics 103) from January 2009 to December 2012 were retrospectively reviewed; 132 were cirrhosis-related re-admissions. The statistical analysis was performed using STATA version 11.1. Chi-square/Fisher's exact and Student's t-tests were used to compare categorical and continuous variables, respectively. Multivariate logistic regression analysis was performed to identify predictors for hospital readmissions.

RESULTS: Among the 132 cirrhosis-related readmissions, 71% were Hispanics while 29% were non-Hispanics (P=0.035). Hepatic encephalopathy (HE) and esophageal variceal hemorrhage were the most frequent causes of the first and subsequent readmissions. Hispanics with readmissions had a higher Child-Turcotte-Pugh (CTP) class (B and C) and higher model for end-stage liver disease (MELD) scores (≥15), as well as a higher incidence of alcohol use, HE, spontaneous bacterial peritonitis, hepatocellular carcinoma, and varices (P<0.05). The majority of the study patients (81%) had MELD scores <15. Multivariate regression analysis identified alcohol use (OR 2.63; 95%CI 1.1-6.4), HE (OR 5.5; 95%CI 2-15.3), varices (OR 3.2; 95%CI 1.3-8.2), and CTP class (OR 3.3; 95%CI 1.4-8.1) as predictors for readmissions among Hispanics.

CONCLUSION: CTP classes B and C, among other factors, were the major predictors for hospital readmissions in Hispanics with HCV-related cirrhosis. The majority of these readmissions were due to HE and variceal hemorrhage.

Keywords: Child-Turcotte-Pugh class; hepatic encephalopathy; non-Hispanics; prophylactic β-blockers; variceal hemorrhage

Conflict of interest statement

None

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