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Validation of risk score in predicting early readmissions in decompensated cirrhotic patients: A model based on the administrative database

Hepatology Aug 16, 2019

Mumtaz K, Issak A, Porter K, et al. - In order to construct a validated risk model for early readmission prediction in patients with decompensated cirrhosis, as well as to determine the 30-day all-cause readmission rate and the most common causes for readmission, researchers undertook this retrospective cohort study using the 2013 and 2014 Nationwide Readmission Database (NRD). They determined the predictors of readmissions by fitting a multivariable logistic regression model. Ultimately, they succeed at developing the Mumtaz readmission risk score, which was validated on the 2014 NRD. Independent predictors of 30-day readmission were age < 65 years; Medicare or Medicaid insurance; nonalcoholic cause of cirrhosis; ≥ 3 Elixhauser score; presence of hepatic encephalopathy, ascites, variceal bleeding, hepatocellular carcinoma, paracentesis, or hemodialysis; and discharge against medical advice. Readmission within 30 days of discharge was sought by one third of patients. A refined prediction of 30-day readmission in high-risk patients can be achieved with the use of a simple risk scoring model with high generalizability, based on demographics, clinical characteristics, and interventions. The requirement for targeted interventions to reduce readmission was highlighted by the Mumtaz readmission risk score.
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