Early predictors of outcomes of hospitalization for cirrhosis and assessment of the impact of race and ethnicity at safety-net hospitals
| العنوان: | Early predictors of outcomes of hospitalization for cirrhosis and assessment of the impact of race and ethnicity at safety-net hospitals |
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| المؤلفون: | Bashar M. Attar, Moinuddin Syed, Samuel Akinyeye, Maya Balakrishnan, James E. Slaven, Lauren Nephew, Zachary P. Fricker, Eduardo Vilar-Gomez, Naga Chalasani, V.V. Pavan Kedar Mukthinuthalapati, Michelle T. Long, Eric S. Orman, Marwan Ghabril |
| المصدر: | PLoS ONE PLoS ONE, Vol 14, Iss 3, p e0211811 (2019) |
| بيانات النشر: | Public Library of Science, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Liver Cirrhosis, Male, Cirrhosis, Comorbidity, Pediatrics, Liver disease, 0302 clinical medicine, Medicine and Health Sciences, Ethnicity, Ethnicities, Hispanic People, Multidisciplinary, Mortality rate, Liver Diseases, Middle Aged, Hospitals, Hospitalization, 030220 oncology & carcinogenesis, Cohort, Medicine, 030211 gastroenterology & hepatology, Female, Research Article, medicine.medical_specialty, Gastrointestinal bleeding, Death Rates, Science, Surgical and Invasive Medical Procedures, Gastroenterology and Hepatology, Lower risk, Patient Readmission, 03 medical and health sciences, Digestive System Procedures, Population Metrics, Internal medicine, medicine, Humans, Retrospective Studies, Transplantation, Population Biology, business.industry, Biology and Life Sciences, Retrospective cohort study, Organ Transplantation, medicine.disease, Liver Transplantation, Health Care, Health Care Facilities, People and Places, Population Groupings, business, Safety-net Providers |
| الوصف: | BackgroundSafety-net hospitals provide care for racially/ethnically diverse and disadvantaged urban populations. Their hospitalized patients with cirrhosis are relatively understudied and may be vulnerable to poor outcomes and racial/ethnic disparities.AimsTo examine the outcomes of patients with cirrhosis hospitalized at regionally diverse safety-net hospitals and the impact of race/ethnicity.MethodsA study of patients with cirrhosis hospitalized at 4 safety-net hospitals in 2012 was conducted. Demographic, clinical factors, and outcomes were compared between centers and racial/ethnic groups. Study endpoints included mortality and 30-day readmission.ResultsIn 2012, 733 of 1,212 patients with cirrhosis were hospitalized for liver-related indications (median age 55 years, 65% male). The cohort was racially diverse (43% White, 25% black, 22% Hispanic, 3% Asian) with cirrhosis related to alcohol and viral hepatitis in 635 (87%) patients. Patients were hospitalized mainly for ascites (35%), hepatic encephalopathy (20%) and gastrointestinal bleeding (GIB) (17%). Fifty-four (7%) patients died during hospitalization and 145 (21%) survivors were readmitted within 30 days. Mortality rates ranged from 4 to 15% by center (p = .007) and from 3 to 10% by race/ethnicity (p = .03), but 30-day readmission rates were similar. Mortality was associated with Model for End-stage Liver Disease (MELD), acute-on-chronic liver failure, hepatocellular carcinoma, sodium and white blood cell count. Thirty-day readmission was associated with MELD and Charlson Comorbidity Index >4, with lower risk for GIB. We did not observe geographic or racial/ethnic differences in hospital outcomes in the risk-adjusted analysis.ConclusionsHospital mortality and 30-day readmission in patients with cirrhosis at safety-net hospitals are associated with disease severity and comorbidities, with lower readmissions in patients admitted for GIB. Despite geographic and racial/ethnic differences in hospital mortality, these factors were not independently associated with mortality. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::205e6430580871b126d3673a6dcee1b7Test http://europepmc.org/articles/PMC6402644Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....205e6430580871b126d3673a6dcee1b7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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