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预测肝硬化患者一年再入院的生物标志物和社会人口学因素
Authors Dai J, Zhao J, Du Y, McNeil EB, Chongsuvivatwong V
Received 1 February 2019
Accepted for publication 25 July 2019
Published 8 August 2019 Volume 2019:15 Pages 979—989
DOI https://doi.org/10.2147/TCRM.S203883
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 3
Editor who approved publication: Professor Deyun Wang
Background: Hospital readmissions of patients with cirrhosis is a current problem in China. This study aims to estimate the readmission rate at one year after discharge and to identify associated risk factors of hospital readmission.
Methods: Between January 2012 and December 2015, 3,402 patients admitted with cirrhosis were included in the study. The primary outcome was one-year inpatient readmission. Principal components analysis was conducted on the laboratory test indicators to reduce the number of dimensions. Univariate and multivariate analyses were performed using clinical and demographic data to identify independent associated factors of readmission within one year. The odds ratio (OR) and 95% confidence interval were used to assess the strength of association for each factor.
Results: Two dimensions, namely “liver function” and “renal function”, were revealed. Patients with a longer length of stay in the index admission (OR: 1.03; 95% CI: 1.03–1.04) and a higher dimension score of liver function (OR: 1.09; 95% CI: 1.05–1.13) were more likely to be readmitted within one-year. Older patients had a significantly higher odds of one-year readmission than younger patients (OR: 1.61; 95% CI: 1.22–2.11), patients who were married had a higher odds than those who were single (OR: 1.62; 95% CI: 1.12–2.36), and patients with hepatitis C virus were more likely to be readmitted within one year than patients with hepatitis B virus (OR: 1.51; 95% CI: 1.19–1.91).
Conclusion: Biomarkers and sociodemographic factors can identify patients at high risk for readmission within one year. Our data indicates the need to emphasize proper liver care to older patients who have been hospitalized for a long time.
Keywords: cirrhosis, readmission, liver function, renal function