Randomized Intervention and Outpatient Follow-Up Lowers 30-D Readmissions for Patients With Hepatic Encephalopathy, Decompensated Cirrhosis

Authors

Antoinette Pusateri
Kevin Litzenberg
Claire Griffiths
Caitlin Hayes
Bipul Gnyawali
Michelle Manious
Sean G Kelly
Lanla F Conteh
Sajid Jalil
Haikady N Nagaraja
Khalid Mumtaz

Publication Date

6-27-2023

Journal

World Journal of Hepatology

Abstract

BACKGROUND: We previously reported national 30-d readmission rates of 27% in patients with decompensated cirrhosis (DC).

AIM: To study prospective interventions to reduce early readmissions in DC at our tertiary center.

METHODS: Adults with DC admitted July 2019 to December 2020 were enrolled and randomized into the intervention (INT) or standard of care (SOC) arms. Weekly phone calls for a month were completed. In the INT arm, case managers ensured outpatient follow-up, paracentesis, and medication compliance. Thirty-day readmission rates and reasons were compared.

RESULTS: Calculated sample size was not achieved due to coronavirus disease 2019; 240 patients were randomized into INT and SOC arms. 30-d readmission rate was 33.75%, 35.83% in the INT

CONCLUSION: Our 30-d readmission rate was higher than the national rate but reduced by interventions in patients with DC with HE and early outpatient follow-up. Development of interventions to reduce early readmission in patients with DC is needed.

Keywords

Decompensated cirrhosis, Hospital readmissions, Interventions