Heart failure (HF) patients who also have cirrhosis of the liver face a heightened risk of 30-day rehospitalization, according to new data published in Current Problems in Cardiology.
In the study, researchers performed a cross-sectional analysis of the Nationwide Readmissions Database, focusing on data from 2010 to 2012. The analysis included 2,147,363 index hospitalizations for decompensated HF, and 1.2% of patients presented with cirrhosis. Sixty-four percent of patients were men, and the mean patient age was 65 years old.
Patients with cirrhosis were more likely to be male. They also had higher odds of presenting with coexisting hypertension, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes mellitus or peripheral vascular disease. They were also more likely to be diagnosed with acute kidney injury during their index hospitalization.
However, patients with cirrhosis faced a similar risk of chronic kidney disease or cancer compared with patients without cirrhosis.
In the study, 21.9% of HF patients were readmitted within 30-days. Patients with cirrhosis had a "significantly higher" chance of being readmitted, and that risk was even higher if the patient presented with non-alcoholic cirrhosis.
“In this analysis of HF readmissions, comorbid cirrhosis was associated with a higher risk of readmission at 30 days,” wrote lead author Ali Yazdanyar, DO, PhD, MS, with the department of emergency medicine and hospital medicine at Lehigh Valley Hospital-Cedar Crest in Allentown, Pennsylvania, and colleagues. “Although these patients may only account for a minority of total discharges, their complex underlying medical condition should allow for increased resources to assist in caring for them.”
Yazdanyar et al. noted that this patient cohort are critically ill, vulnerable and require "disease-specific interventions through a multispecialty consensus approach" as a way to prevent the emergence of complications, including hepatocardiorenal syndromes.
“It is then imperative to identify causes of avoidable readmissions and other barriers so that changes can be made by our healthcare systems to benefit this complex patient population and optimize clinical outcome,” the authors wrote.
Read the full study here.