Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis

IntroductionLiver disease remains a significant global health concern. In China, the number of patients with liver cirrhosis is estimated to reach 7 million. In addition to the high risk of death, cirrhosis leads to several severe complications. Patients with cirrhosis have significantly longer hosp...

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Main Authors: Shan Wang, Lin Zhang, Jin Li, Jiajun Feng, Jie Gao, Rui Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1417222/full
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author Shan Wang
Shan Wang
Lin Zhang
Jin Li
Jiajun Feng
Jie Gao
Rui Huang
author_facet Shan Wang
Shan Wang
Lin Zhang
Jin Li
Jiajun Feng
Jie Gao
Rui Huang
author_sort Shan Wang
collection DOAJ
description IntroductionLiver disease remains a significant global health concern. In China, the number of patients with liver cirrhosis is estimated to reach 7 million. In addition to the high risk of death, cirrhosis leads to several severe complications. Patients with cirrhosis have significantly longer hospital stays and higher total hospital costs than those without cirrhosis. We aimed to investigate the predictors of readmission among patients with cirrhosis in China.Materials and methodsWe conducted a retrospective study to evaluate adult patients with cirrhosis. Data on various sociodemographic, clinical, and hospitalization characteristics were collected. We defined the primary endpoint as the first liver-related readmission occurring within 30–90 days of initial hospitalization. Adult patients with cirrhosis admitted to our hospital between January 2009 and December 2022 were included. Differences between groups were analyzed using Student’s t-test and chi-square test. Logistic and multiple linear regression analyses were performed to identify predictors associated with readmission and the length of the first hospitalization.ResultsIn total, 1,285 patients were diagnosed with cirrhosis. Among these patients, 767 (59.7%) were males, and the mean age was 58.9 ± 12.3 years. Seventy-two (5.6%) and 154 (12.0%) patients were readmitted within 30 and 90 days, respectively. Compared with those who were not readmitted, patients readmitted at 30-day and 90-day had a higher proportion of males, ascites, spontaneous bacterial peritonitis, electrolyte abnormalities, higher Child-Pugh–Turcotte scores, longer initial hospital stays, and higher initial hospitalization costs. Logistic regression analysis indicated that hepatic encephalopathy, spontaneous bacterial peritonitis, diabetes, and ascites were predictors of 30- and 90-day readmission. Hypertension and spontaneous bacterial peritonitis were significant predictors of the length of the first hospitalization.ConclusionPatients with cirrhosis presenting with hepatic encephalopathy, ascites, and spontaneous bacterial peritonitis may have a higher risk of rehospitalization.
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spelling doaj-art-c7eea161b2814043ad32e3ced900c3ef2025-01-31T06:40:05ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011210.3389/fmed.2025.14172221417222Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosisShan Wang0Shan Wang1Lin Zhang2Jin Li3Jiajun Feng4Jie Gao5Rui Huang6Peking University Hepatology Institute, Peking University People’s Hospital, Beijing, ChinaDepartment of Liver Diseases, The First Hospital of Lanzhou University, Lanzhou, ChinaPeking University Hepatology Institute, Peking University People’s Hospital, Beijing, ChinaThe First Department of Neurology, The Third People’s Hospital of Liaoyang, Liaoyang, ChinaDepartment of Marketing, School of Business, Renmin University of China, Beijing, ChinaDepartment of Hepatobiliary Surgery, Peking University People’s Hospital, Beijing, ChinaPeking University Hepatology Institute, Peking University People’s Hospital, Beijing, ChinaIntroductionLiver disease remains a significant global health concern. In China, the number of patients with liver cirrhosis is estimated to reach 7 million. In addition to the high risk of death, cirrhosis leads to several severe complications. Patients with cirrhosis have significantly longer hospital stays and higher total hospital costs than those without cirrhosis. We aimed to investigate the predictors of readmission among patients with cirrhosis in China.Materials and methodsWe conducted a retrospective study to evaluate adult patients with cirrhosis. Data on various sociodemographic, clinical, and hospitalization characteristics were collected. We defined the primary endpoint as the first liver-related readmission occurring within 30–90 days of initial hospitalization. Adult patients with cirrhosis admitted to our hospital between January 2009 and December 2022 were included. Differences between groups were analyzed using Student’s t-test and chi-square test. Logistic and multiple linear regression analyses were performed to identify predictors associated with readmission and the length of the first hospitalization.ResultsIn total, 1,285 patients were diagnosed with cirrhosis. Among these patients, 767 (59.7%) were males, and the mean age was 58.9 ± 12.3 years. Seventy-two (5.6%) and 154 (12.0%) patients were readmitted within 30 and 90 days, respectively. Compared with those who were not readmitted, patients readmitted at 30-day and 90-day had a higher proportion of males, ascites, spontaneous bacterial peritonitis, electrolyte abnormalities, higher Child-Pugh–Turcotte scores, longer initial hospital stays, and higher initial hospitalization costs. Logistic regression analysis indicated that hepatic encephalopathy, spontaneous bacterial peritonitis, diabetes, and ascites were predictors of 30- and 90-day readmission. Hypertension and spontaneous bacterial peritonitis were significant predictors of the length of the first hospitalization.ConclusionPatients with cirrhosis presenting with hepatic encephalopathy, ascites, and spontaneous bacterial peritonitis may have a higher risk of rehospitalization.https://www.frontiersin.org/articles/10.3389/fmed.2025.1417222/fullliver cirrhosisreadmissionhepatic encephalopathyspontaneous bacterial peritonitishypertension
spellingShingle Shan Wang
Shan Wang
Lin Zhang
Jin Li
Jiajun Feng
Jie Gao
Rui Huang
Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis
Frontiers in Medicine
liver cirrhosis
readmission
hepatic encephalopathy
spontaneous bacterial peritonitis
hypertension
title Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis
title_full Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis
title_fullStr Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis
title_full_unstemmed Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis
title_short Hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver-related readmissions in cirrhosis
title_sort hepatic encephalopathy and spontaneous bacterial peritonitis are associated with increased liver related readmissions in cirrhosis
topic liver cirrhosis
readmission
hepatic encephalopathy
spontaneous bacterial peritonitis
hypertension
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1417222/full
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AT linzhang hepaticencephalopathyandspontaneousbacterialperitonitisareassociatedwithincreasedliverrelatedreadmissionsincirrhosis
AT jinli hepaticencephalopathyandspontaneousbacterialperitonitisareassociatedwithincreasedliverrelatedreadmissionsincirrhosis
AT jiajunfeng hepaticencephalopathyandspontaneousbacterialperitonitisareassociatedwithincreasedliverrelatedreadmissionsincirrhosis
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