Rates, Reasons, and Independent Predictors of Readmissions in Portal Venous Thrombosis Hospitalizations in the USA.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Gastroenterology Research Pub Date : 2022-10-01 Epub Date: 2022-10-19 DOI:10.14740/gr1561
Robert Kwei-Nsoro, Pius Ojemolon, Hisham Laswi, Ebehiwele Ebhohon, Abdultawab Shaka, Wasey Ali Mir, Abdul Hassan Siddiqui, Jobin Philipose, Hafeez Shaka
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引用次数: 4

Abstract

Background: Portal vein thrombosis (PVT), generally considered rare, is becoming increasingly recognized with advanced imaging. Limited data exist regarding readmissions in PVT and its burden on the overall healthcare cost. This study aimed to outline the burden of PVT readmissions and identify the modifiable predictors of readmissions.

Methods: The National Readmission Database (NRD) was used to identify PVT admissions from 2016 to 2019. Using the patient demographic and hospital-specific variables within the NRD, we grouped patient encounters into two cohorts, 30- and 90-day readmission cohorts. We assessed comorbidities using the validated Elixhauser comorbidity index. We obtained inpatient mortality rates, mean length of hospital stay (LOS), total hospital cost (THC), and causes of readmissions in both 30- and 90-day readmission cohorts. Using a multivariate Cox regression analysis, we identified the independent predictors of 30-day readmissions.

Results: We identified 17,971 unique index hospitalizations, of which 2,971 (16.5%) were readmitted within 30 days. The top five causes of readmissions in both 30-day and 90-day readmission cohorts were PVT, sepsis, hepatocellular cancer, liver failure, and alcoholic liver cirrhosis. The following independent predictors of 30-day readmission were identified: discharge against medical advice (AMA) (adjusted hazard ratio (aHR) 1.86; P = 0.002); renal failure (aHR 1.44, P = 0.014), metastatic cancer (aHR 1.31, P = 0.016), fluid and electrolyte disorders (aHR 1.20, P = 0.004), diabetes mellitus (aHR 1.31, P = 0.001) and alcohol abuse (aHR 1.31, P ≤ 0.001).

Conclusion: The readmission rate identified in this study was higher than the national average and targeted interventions addressing these factors may help reduce the overall health care costs.

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美国门静脉血栓再入院的比率、原因和独立预测因素。
背景:门静脉血栓形成(PVT)通常被认为是罕见的,随着先进的影像学越来越被认识到。关于PVT再入院及其对总体医疗成本负担的数据有限。本研究旨在概述PVT再入院的负担,并确定再入院的可修改预测因素。方法:使用国家再入院数据库(NRD)对2016年至2019年的PVT入院情况进行识别。使用NRD中的患者人口统计学和医院特定变量,我们将患者分组为两个队列,30天和90天再入院队列。我们使用Elixhauser合并症指数评估合并症。在30天和90天的再入院队列中,我们获得了住院死亡率、平均住院时间(LOS)、总住院费用(THC)和再入院原因。使用多变量Cox回归分析,我们确定了30天再入院的独立预测因素。结果:我们确定了17971例独特指数住院,其中2971例(16.5%)在30天内再次入院。在30天和90天的再入院队列中,再入院的前五大原因是PVT、败血症、肝细胞癌、肝功能衰竭和酒精性肝硬化。确定了以下30天再入院的独立预测因素:不遵医嘱出院(调整风险比(aHR) 1.86;P = 0.002);肾衰竭(aHR 1.44, P = 0.014)、转移性癌症(aHR 1.31, P = 0.016)、体液和电解质紊乱(aHR 1.20, P = 0.004)、糖尿病(aHR 1.31, P = 0.001)和酗酒(aHR 1.31, P≤0.001)。结论:本研究确定的再入院率高于全国平均水平,针对这些因素的有针对性的干预措施可能有助于降低总体卫生保健成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Gastroenterology Research
Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-
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