Singal et al identified a number of factors associated with 30-day hospital readmission rates for patients with cirrhosis. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Texas Southwestern Medical Center, Parkland Health and Hospital and the Medical University of South Carolina.


Patient selection: hospitalized patient with cirrhosis


Risk factors associated with hospital readmission within 30 days:

(1) frequent changes of address

(2) multiple hospital admissions in the past year

(3) Medicaid insurance

(4) low serum concentration of ALT

(5) anemia (hematocrit <= 30%)

(6) hyponatremia (serum sodium <= 130 mmol/L)

(7) high MELD score

(8) not thrombocytopenic (platelet count > 174,000 per µL)



• A low serum ALT may reflect end-stage liver disease with a small number of functioning hepatocytes.


Predictors of 90-day mortality rate (in Supplemental Appendix):

(1) Medicaid insurance

(2) hyponatremia (serum sodium <= 130 mmol/L)

(3) not thrombocytopenic

(4) anemia (hematocrit <= 30%)

(5) high MELD score

(6) 30-day readmission


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