Abraham Ifrah, MD, MS, Ho-Man Yeung, MD Temple University Hospital, Philadelphia, PA
Introduction: Patients with newly diagnosed cirrhosis are particularly vulnerable to readmissions and death after discharge from the hospital. We sought to examine the relationship of discharge disposition (home vs facility discharges) with readmission, mortality, and hepatology clinic follow up.
Methods: We conducted a retrospective chart review of 229 patients with newly diagnosed cirrhosis, admitted for decompensated cirrhosis between Jan 2020-Dec 2021. Patients on chronic dialysis were excluded. Demographic, disposition, and readmission information was analyzed.
Results: Out of 229 patients, 145 were discharged to home, 32 to facilities, and 37 expired or discharged to hospice (Figure 1). Regarding home discharges, 41 (28%) were readmitted, 103 (71%) had an appointment requested with 64 (44%) patients had subsequent outpatient appointment. Regarding facility discharges, 10 (32%) were readmitted, 21 (65%) had an appointment requested, and 14 (43%) had outpatient follow up. Those without appointment requests experience higher odds of readmissions than those with appointment requests: OR=1.3 for home discharges vs OR=2.0 for facility discharges. Deaths were higher without appointment requested: OR=1.7 for home discharges vs OR=1.4 for facility discharges. With regards to death, 29 (20%) were discharged to home while 11 (34%) were discharged to facilities. The median overall survival time was 116 days for home discharges compared to 25 days for facility discharges.
Discussion: Readmission and follow-up rates are similar between home and facility discharges. Even in a controlled environment, patients are susceptible to readmission and barriers similar to home discharges. Facility discharges experienced shorter overall survival time and higher death rate. These findings would suggest that patients discharged to facilities are of higher complexity. This study emphasizes the importance of discharging patients with adequate follow up plan for patients with newly diagnosed cirrhosis regardless of disposition. Further studies should focus on interventions to decrease readmission rates and improve outpatient follow up rates.
Figure: Discharge Disposition for Patients with Newly Diagnosed Cirrhosis.
Disclosures:
Abraham Ifrah indicated no relevant financial relationships.
Ho-Man Yeung indicated no relevant financial relationships.
Abraham Ifrah, MD, MS, Ho-Man Yeung, MD. P2434 - Does Discharge Disposition Affect Follow-Up, Readmission, and Mortality in Patients With Newly Diagnosed Cirrhosis?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
