• Eric S Orman, Marwan Ghabril, Thomas W Emmett, and Naga Chalasani.
• Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana.
• J Hosp Med. 2018 Jul 1; 13 (7): 490495490-495.

BackgroundHospital readmission is a significant problem for patients with complex chronic illnesses such as liver cirrhosis.PurposeWe aimed to describe the range of readmission risk in patients with cirrhosis and the impact of the model for end-stage liver disease (MELD) score.Data SourcesWe conducted a systematic review of studies identified in Ovid MEDLINE, PubMed, EMBASE, CINAHL, the Cochrane Library, Scopus, Google Scholar, and ClinicalTrials.gov from 2000 to May 2017.Study SelectionWe examined studies that reported early readmissions (up to 90 days) in patients with cirrhosis. Studies were excluded if they did not examine the association between readmission and at least 1 variable or intervention.Data ExtractionTwo reviewers independently extracted data on study design, setting, population, interventions, comparisons, and detailed information on readmissions.Data SynthesisOf the 1363 records reviewed, 26 studies met the inclusion and exclusion criteria. Of these studies, 21 were retrospective, and there was significant variation in the inclusion and exclusion criteria. The pooled estimate of 30-day readmissions was 26%(95% confidence interval [CI], 22%-30%). Few studies examined readmission preventability or the relationship between readmissions and social determinants of health. Reasons for readmission were highly variable. An increased MELD score was associated with readmissions in most studies. Readmission was associated with increased mortality.ConclusionHospital readmissions frequently occur in patients with cirrhosis and are associated with liver disease severity. The impact of functional and social factors on readmissions is unclear.© 2018 Society of Hospital Medicine.

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