Mumtaz et al reported a score for predicting the risk of readmission for an adult with cirrhosis. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Ohio State University, University of South Carolina and Catalyst Medical Consulting.
Patient selection: >= 18 years with cirrhosis
Parameters:
(1) age of the patient in years
(2) primary payer
(3) Elixhauser comorbidity score
(4) etiology of the cirrhosis
(5) ascites
(6) hepatic encephalopathy
(7) variceal bleeding
(8) hepatocellular carcinoma
(9) paracentesis during admission
(10) hemodialysis during admission
(11) disposition at discharge
Parameter
Finding
Points
age of the patient
18 to 39 years
7
40 to 64 years
4
>= 65 years
0
primary payer
Medicare
4
Medicaid
5
private insurance
0
self-pay
-3
no charge or other
-1
Elixhauser comorbidity
< 3
0
>= 3
2
etiology of cirrhosis
alcoholic
0
non-alcoholic
2
ascites
no
0
yes
5
hepatic encephalopathy
no
0
yes
4
variceal bleeding
no
0
yes
-7
hepatocellular carcinoma
no
0
yes
3
paracentesis
no
0
yes
4
hemodialysis
no
0
yes
7
disposition
routine
0
transfer
-1
home health care
1
against advice
10
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: -11
• maximum score: 49
• The higher the score the greater the risk of readmission.
Score
Risk of Readmission
<= 6
low
7 to 19 (or 17)
medium
20 (or 18) to 49
high
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