AASLD The Liver Meeting® 2015 Conference Research Round-Up

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Four Factors Predict Readmission among Post-Surgical Patients with Decompensated Cirrhosis

By Annette Boyle and Brenda Mooney, MDalert.com contributors.
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San Francisco—According to current projections, by 2020 more than 1 million individuals in the US will have cirrhosis. Many of these will require surgery and hospitalization. Accurately predicting which patients have the highest risk of readmission so that resources can be prioritized to them would have a significant effect on patient health and safety and for healthcare costs.

These findings were presented by M Schmidt and colleagues in poster 14 at the 2015 annual meeting of the AASLD, held here recently. You can find the entire abstract here.

Using the National Surgical Quality Improvement Program data (NSQIP) from 2011 to 2013, researchers identified patients with cirrhosis. Analysis of the 5,879 patients found 739 readmissions within 30 days. Among those individuals, 4 factors proved strong predictors of readmission within 30 days:

  1. Insulin dependent diabetes (OR 3.4 CI 1.6-7.3)
  2. Discharged home (OR 3.4 CI 1.5-8.7)
  3. ASA class 4-life threatening (OR 4.7 CI 1.8-12.1)
  4. Days from surgery to discharge (OR 0.94 CI 0.91-0.97).

A model using the 4 factors had a sensitivity of 86% and a specificity of 61% using a cut-point of 0.08 for classification. The new model significantly outperformed the Model for End-stage Liver Disease (MELD) score for predicting readmissions.


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