P2386 - Independent Predictors of Readmission in Cirrhosis Patients With Nonvariceal Upper Gastrointestinal Bleeding

Harjit Singh, MD, Bryce Kunkle, MD, Bruce Luxon, MD, PhD
MedStar Georgetown University Hospital, Washington, DC

Introduction: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a cirrhotic complication associated with significant morbidity and mortality. National outcomes data regarding predictors of readmission remains limited. Therefore, our study attempted to examine independent predictors of readmission in cirrhosis patients with NVUGIB.



Methods: Nationwide Readmissions Database (NRD) using the year 2020 data was examined to evaluate outcomes of patients with NVUGIB. Patients were stratified into groups including compensated cirrhosis (CC), decompensated cirrhosis (DC), and no cirrhosis (NC). International Classification of Diseases, Tenth Revision, was used to identify all diagnoses and procedures. Our primary outcome was identification of predictors of readmission. A multivariate logistic regression model was implemented that controlled for age, sex, socioeconomic status, and insurance payer to independently identify predictors of readmission.

Results: A total of 86,022 patients with NVUGIB were identified. DC (1.15 OR: (1.063-1.233), p < 0.001) and CC (1.078 OR: 1.014-1.144) were both independently associated with higher rates of readmission. Multivariable analysis also demonstrated that older age (1.004 OR: (1.003-1.005), p< 0.001­), male sex (1.050 OR: (1.019-1.082), p< 0.001­), bottom income quartile (1.086 OR: (1.045-1.128), p< 0.001­), and higher Deyo index (1.146 OR: (1.140-1.152), p< 0.001­) were independently associated with higher readmission risk. Private insurance status (0.599 OR: (0.574-0.627), p< 0.001­) was associated with reduced risk of readmission.

Discussion: Our results suggest that DC and CC are associated with significantly higher rates of readmission. Furthermore, in addition to DC and CC, elder age, male sex, lower socioeconomic status, and higher comorbidity status are independently associated with higher rates of readmission. Higher income and private insurance status were significantly associated with lower rates of readmission. These findings can be used to inform outcomes and guide management in this complex patient population.


Disclosures:


Harjit Singh, MD, Bryce Kunkle, MD, Bruce Luxon, MD, PhD. P2386 - Independent Predictors of Readmission in Cirrhosis Patients With Nonvariceal Upper Gastrointestinal Bleeding, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.