Dataset Information

Hospital Readmissions in Patients with Cirrhosis: A Systematic Review.

ABSTRACT:

Background

Hospital readmission is a significant problem for patients with complex chronic illnesses such as liver cirrhosis.

Purpose

We aimed to describe the range of readmission risk in patients with cirrhosis and the impact of the model for end-stage liver disease (MELD) score.

Data sources

We conducted a systematic review of studies identified in Ovid MEDLINE, PubMed, EMBASE, CINAHL, the Cochrane Library, Scopus, Google Scholar, and ClinicalTrials.gov from 2000 to May 2017.

Study selection

We examined studies that reported early readmissions (up to 90 days) in patients with cirrhosis. Studies were excluded if they did not examine the association between readmission and at least 1 variable or intervention.

Data extraction

Two reviewers independently extracted data on study design, setting, population, interventions, comparisons, and detailed information on readmissions.

Data synthesis

Of the 1363 records reviewed, 26 studies met the inclusion and exclusion criteria. Of these studies, 21 were retrospective, and there was significant variation in the inclusion and exclusion criteria. The pooled estimate of 30-day readmissions was 26%(95% confidence interval [CI], 22%-30%). Few studies examined readmission preventability or the relationship between readmissions and social determinants of health. Reasons for readmission were highly variable. An increased MELD score was associated with readmissions in most studies. Readmission was associated with increased mortality.

Conclusion

Hospital readmissions frequently occur in patients with cirrhosis and are associated with liver disease severity. The impact of functional and social factors on readmissions is unclear.

SUBMITTER: Orman ES

PROVIDER: S-EPMC6202277 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Hospital Readmissions in Patients with Cirrhosis: A Systematic Review.

Orman Eric S ES Ghabril Marwan M Emmett Thomas W TW Chalasani Naga N

Journal of hospital medicine 20180701 7

<h4>Background</h4>Hospital readmission is a significant problem for patients with complex chronic illnesses such as liver cirrhosis.<h4>Purpose</h4>We aimed to describe the range of readmission risk in patients with cirrhosis and the impact of the model for end-stage liver disease (MELD) score.<h4>Data sources</h4>We conducted a systematic review of studies identified in Ovid MEDLINE, PubMed, EMBASE, CINAHL, the Cochrane Library, Scopus, Google Scholar, and ClinicalTrials.gov from 2000 to May 2 ...[more]

PMID: 29694458

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Project description:ObjectiveTo synthesise evidence on risk factors associated with paediatric unplanned hospital readmissions (UHRs).DesignSystematic review.Data sourceCINAHL, EMBASE (Ovid) and MEDLINE from 2000 to 2017.Eligibility criteriaStudies published in English with full-text access and focused on paediatric All-cause, Surgical procedure and General medical condition related UHRs were included.Data extraction and synthesisCharacteristics of the included studies, examined variables and the statistically significant risk factors were extracted. Two reviewers independently assessed study quality based on six domains of potential bias. Pooling of extracted risk factors was not permitted due to heterogeneity of the included studies. Data were synthesised using content analysis and presented in narrative form.ResultsThirty-six significant risk factors were extracted from the 44 included studies and presented under three health condition groupings. For All-cause UHRs, ethnicity, comorbidity and type of health insurance were the most frequently cited factors. For Surgical procedure related UHRs, specific surgical procedures, comorbidity, length of stay (LOS), age, the American Society of Anaesthesiologists class, postoperative complications, duration of procedure, type of health insurance and illness severity were cited more frequently. The four most cited risk factors associated with General medical condition related UHRs were comorbidity, age, health service usage prior to the index admission and LOS.ConclusionsThis systematic review acknowledges the complexity of readmission risk prediction in paediatric populations. This review identified four risk factors across all three health condition groupings, namely comorbidity; public health insurance; longer LOS and patients<12 months or between 13-18 years. The identification of risk factors, however, depended on the variables examined by each of the included studies. Consideration should be taken into account when generalising reported risk factors to other institutions. This review highlights the need to develop a standardised set of measures to capture key hospital discharge variables that predict unplanned readmission among paediatric patients.

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Dataset Information

Hospital Readmissions in Patients with Cirrhosis: A Systematic Review.

Background

Purpose

Data sources

Study selection

Data extraction

Data synthesis

Conclusion

Publications

Hospital Readmissions in Patients with Cirrhosis: A Systematic Review.

Similar Datasets

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