Donghak Jeong

Hospital Cirrhosis Volume and Readmission in Patients with Cirrhosis in California

BackgroundPatients with cirrhosis are at high readmission risk. Using a large statewide database, we evaluated the effect of hospital cirrhosis-related patient volume on 30-day readmissions in patients with cirrhosis.MethodsWe conducted a retrospective study of the Healthcare Cost and Utilization Project State Inpatient Database for adult patients with cirrhosis, as defined by International Classification of Diseases, Ninth Revision (ICD-9) codes, hospitalized in California between 2009 and 2011. Multivariable logistic regression analysis was performed to evaluate the effect of hospital volume on 30-day readmissions.ResultsA total of 69,612 patients with cirrhosis were identified in 405 hospitals; 24,062 patients were discharged from the top 10% of hospitals (Nxa0=xa041) by cirrhosis volume, and 45,550 patients in the bottom 90% (Nxa0=xa0364). Compared with higher-volume centers, lower-volume hospitals cared for patients with similar average Quan–Charlson–Deyo (QCD) comorbidity scores (6.54 vs. 6.68), similar proportion of hepatitis B and fatty liver disease, lower proportion of hepatitis C (34.8 vs. 41.5%) but greater proportion of alcoholic liver disease (53.1 vs. 47.4%). Multivariable logistic regression analysis demonstrated admission to a lower-volume hospital did not predict 30-day readmission (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.92–1.01) after adjusting for sociodemographics, QCD score, cirrhosis severity, and hospital characteristics. Instead, liver transplant center status significantly decreased the risk of readmission (OR 0.87, 95% CI 0.80–0.94). Ascites, hepatic encephalopathy, hepatocellular carcinoma, higher QCD, and presence of alcoholic liver disease and hepatitis C were also independent predictors.ConclusionsReadmissions within 30xa0days were common among patients with cirrhosis hospitalized in California. While hospital cirrhosis volume did not predict 30-day readmissions, liver transplant center status was protective of readmissions. Medically complicated patients with cirrhosis at hospitals without liver transplant centers may benefit from additional support to prevent readmission.

Higher mortality and hospital charges in patients with cirrhosis and acute respiratory illness: a population-based study

Both cirrhosis and acute respiratory illness (ARI) carry substantial disease and financial burden. To compare hospitalized patients with cirrhosis with ARI to cirrhotic patients without ARI, a retrospective cohort study was conducted using the California Office of Statewide Health Planning and Development database. To balance the groups, propensity score matching (PSM) was used. We identified a total of 46,192 cirrhotic patients during the three study periods (14,049, 15,699, and 16,444 patients, respectively). Among patients hospitalized with cirrhosis, the ARI prevalence was higher in older age groups (pu2009<u20090.001), the Asian population (pu2009=u20090.002), non-Hispanic population (pu2009=u20090.001), and among Medicare patients (pu2009<u20090.001). Compared to controls, patients with ARI had 53.8% higher adjusted hospital charge (

Economic and clinical burden of viral hepatitis in California: A population-based study with longitudinal analysis

122,555 vs.

Factors Associated with Rates of HBsAg Seroclearance in Adults with Chronic HBV Infection: A systematic review and meta-analysis

79,685 per patient per admission, pu2009<u20090.001) and 35.0% higher adjusted in-hospital mortality (pu2009<u20090.001). Older patients, patients with alcoholic liver disease or liver cancer were at particularly higher risk (adjusted hazard ratiou2009=u20092.94 (95% CI: 2.26–3.83), 1.22 (95% CI: 1.02–1.45), and 2.17 (95% CI: 1.76–2.68) respectively, pu2009=u20090.028 to <0.001). Mortality rates and hospital charges in hospitalized cirrhotic patients with ARI were higher than in cirrhotic controls without ARI. Preventive efforts such as influenza and pneumococcal vaccination, especially in older patients and those with liver cancer, or alcoholic liver disease, would be of value.

Changes in Renal Function in Patients With Chronic HBV infection Treated with Tenofovir Disoproxil Fumarate vs Entecavir

Background Economic burden of HBV and HCV infection are trending upwards. Aims Compare hepatitis B virus (HBV) and hepatitis C virus (HCV) related hospital admission rates, charges, mortality rates, causes of death in a US population-based study. Methods Retrospective cohort analysis of HBV and HCV patients from the California Office of Statewide Health Planning and Development (2006–2013) database. Results A total of 23,891 HBV and 148,229 HCV patients were identified. Across the 8-year period, the mean increase for all-cause (

Sa1501 - Treatment of Chronic Hepatitis B and Renal Impairment in Patients with and without Cirrhosis

1,863 vs

Tu1447 - Adherence to Hepatocellular Carcinoma Surveillance Guidelines in Patients with Liver Cirrhosis: A Population-Based Real-World Study

1,388) and liver-related hospitalization charges (

Sa1483 - Real-World Rates of Hepatitis B Surface Antigen (HBSAG) Seroclearance in Patients with Chronic Hepatitis B (CHB): A Systematic Review, Conventional Aggregated Data Meta-Analysis (ADMA) and Individual Patient Data Meta-Analysis (IPDMA)

1,175 vs

Sa1493 - Estimating the Number of Undiagnosed Patients and Antiviral Treatment Rate for Chronic Hepatitis B in the United States Using the Truven Health Marketscan Database

675) were significantly higher for the HBV cohort compared to the HCV cohort. HBV patients had significantly higher liver-related hospital charges per person per year than HCV patients after controlling for covariates (

360 - Higher In-Hospital and Post-Discharge Mortality and Hospital Charges in Cirrhotic Patients with Acute Respiratory Illness in the United States

123,239 vs