Association Between Cirrhosis and 30-Day Rehospitalization After Index Hospitalization for Heart Failure

Authors

Ali Yazdanyar, Department of Emergency and Hospital Medicine, Lehigh Valley Hospital-Cedar Crest, Allentown, PA; Morsani College of Medicine, University of South Florida, Tampa, FL.
Kevin Bryan Lo, Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.
Jerald Pelayo, Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA. Electronic address: pelayoje@einstein.edu.
Julien Sanon, Department of Emergency and Hospital Medicine, Lehigh Valley Hospital-Cedar Crest, Allentown, PA.
Ardel Romero, Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.
Eduardo Quintero, Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.
Arjan Ahluwalia, Department of Medicine, Lehigh Valley Hospital-Cedar Crest, Allentown, PA.
Shuchita Gupta, University Advanced Heart Failure Center, University Heart and Vascular Institute, Augusta GA.
Rajiv Sankaranarayanan, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK.
Roy Mathew, Division of Nephrology, Columbia VA Health Care System, Columbia, SC, USA.
Janani Rangaswami, Division of Nephrology, George Washington University School of Medicine, Washington DC, USA.

Document Type

Journal Article

Publication Date

10-1-2022

Journal

Current problems in cardiology

Volume

47

Issue

10

DOI

10.1016/j.cpcardiol.2021.100993

Abstract

There are limited data on clinical outcomes in patients re-admitted with decompensated heart failure (HF) with concomitant liver cirrhosis. We conducted a cross sectional analysis of the Nationwide Readmissions Database (NRD) years 2010 thru 2012. An Index admission was defined as a hospitalization for decompensated heart failure among persons aged ≥ 18 years with an alive discharge status. The main outcome was 30 - day all-cause rehospitalization. Survey logistic regression provided the unadjusted and adjusted odds of 30 - day rehospitalization among persons with and without cirrhosis, accounting for age, gender, kidney dysfunction and other comorbidities. There were 2,147,363 heart failure (HF) hospitalizations among which 26,156 (1.2%) had comorbid cirrhosis. Patients with cirrhosis were more likely to have a diagnosis of acute kidney injury (AKI) during their index hospitalization (18.4% vs 15.2%). There were 469,111 (21.9%) patients with readmission within 30 - days. The adjusted odds of a 30 - day readmission was significantly higher among patients with cirrhosis compared to without after adjusting for comorbid conditions (adjusted Odds Ratio [aOR], 1.3; 95% Confidence Interval [CI}: 1.2 to 1.4). The relative risk of 30 - day readmission among those with cirrhosis but without renal disease (aOR, 1.3; 95% CI: 1.3 to 1.3) was lower than those with both cirrhosis and renal disease (aOR, 1.8; 95% CI: 1.6 to 2.0) when compared to persons without either comorbidities. Risk of 30 - day rehospitalization was significantly higher among patients with heart failure and underlying cirrhosis. Concurrent renal dysfunction among patients with cirrhosis hospitalized for decompensated HF was associated with a greater odds of rehospitalization.

APA Citation

Yazdanyar, Ali; Lo, Kevin Bryan; Pelayo, Jerald; Sanon, Julien; Romero, Ardel; Quintero, Eduardo; Ahluwalia, Arjan; Gupta, Shuchita; Sankaranarayanan, Rajiv; Mathew, Roy; and Rangaswami, Janani, "Association Between Cirrhosis and 30-Day Rehospitalization After Index Hospitalization for Heart Failure" (2022). GW Authored Works. Paper 1836.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1836

Department

Medicine