1Department of Pharmaceutical Outcomes & Policy (POP), College of Pharmacy, University of Florida, Gainesville, FL, USA.
2Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
3Bristol-Myers Squibb, Lawrenceville, NJ, USA.
Background: Hepatic encephalopathy (HE) is a complex and reversible neuropsychiatric syndrome that is associated with growing, substantial healthcare resource utilization. We aim to examine the predictors of 30-day readmission and hospitalization cost associated with HE.
Research design and methods: We conducted a cross-sectional study using the Nationwide Readmissions Database from 2010 to 2014. We assessed the readmission rates using multivariate logistic regression and established temporal trends of readmission rates and hospitalization cost. Weighted hierarchical logistic regression and generalized linear mixed models were used to identify predictors for nationally representative readmissions and hospitalization costs, respectively.
Results: The number of index hospitalizations with HE increased with a significant trend from 34,967 in 2010 to 44,791 in 2014. 16.8% of patients were readmitted within 30 days. Predictors increasing readmission risk included female sex, Elixhauser readmission score < 25, elective admission, patient's state residential status, privately insured, number of diagnoses >13, and length of stay >4 days.
Conclusions: Our results indicate there is a need to implement better management strategies to improve outcomes in patients hospitalized with HE to curb the increase in the economic burden associated with the disease.