Title

Identifying Risk Factors for 30-Day Readmissions in Patients with Cirrhosis

Date of Award

12-1-2016

Degree Type

Internship Practicum Report

Degree Name

Master of Science

Field of Study

Clinical Research Management

Department

Graduate School of Biomedical Sciences

First Advisor

Patricia A. Gwirtz

Second Advisor

Ranajit Chakraborty

Abstract

Hospital readmissions have been a main focus of hospitals around the US since 2012. Hospitals with higher than excepted readmission rates are penalized financially and named publically on the CMS website. Cirrhosis is a disease with high readmission rates due to the many complications associated with the disease. The aim of the study is to identify factors that may predict 30-day readmission in patients with cirrhosis.

A total to 262 patients admitted to Baylor Scott and White All Saints Medical Center between September 2013 and September 2015 were included in this study. Patients were initially identified by the following initial diagnoses and ICD-9 codes: alcoholic cirrhosis, cirrhosis not due to alcohol, biliary cirrhosis, hepatic encephalopathy, ascites, hepatorenal syndrome, spontaneous bacterial peritonitis, esophageal varices with bleeding, portal hypertension, or paracentesis. The patients’ height, weight, serum sodium, serum albumin, serum bilirubin, serum creatinine, INR, the number of medications prescribed to the patient at discharge, and whether or not the patient was readmitted within 30 days.

The 30-day readmission rate for this population was 32.4%. A binary logistic regression was performed to find significant predictors of an early readmission. The MELD score and the number of medications prescribed at discharge were significant variables in predicting readmissions for this population. These findings can lead to implementation of new strategies that aim to reduce early readmissions in the cirrhotic population at Baylor Scott and White All Saints Medical Center.

Comments

Tan, Stephen L., Identifying Risk Factors for 30-Day Readmissions in Patients with Cirrhosis. Master of Science (Clinical Research Management), November, 2016, 62 pp., 2 tables, bibliography, 15 titles. Available December 2017.

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