Rate of early hospital readmission amongst cirrhotic patients is high in Australia: experience from a single liver transplant centre

Intern Med J. 2022 Dec;52(12):2086-2095. doi: 10.1111/imj.15932. Epub 2022 Oct 3.


Background and aims: The 30-day hospital readmission rate in cirrhotic patients has been demonstrated to be up to 40% in international studies, but is not well studied in Australia. The aim of the current study was to report on the rate and cause of 30-day hospital readmission from a single liver transplant referral centre, including a cost analysis of readmissions.

Methods: This was a retrospective study of consecutive cirrhotic patients admitted to a liver transplant centre in Victoria, Australia, between 1 January 2019 and 31 December 2019. Cases were identified through International Classification of Diseases, Tenth Revision, 10 coding for cirrhosis and its complications. Baseline demographic data, liver-related complications and unrelated extra-hepatic comorbidities, laboratory values and prognostic scores were collected from the electronic medical record.

Results: One hundred seventy-nine (63% men; median age at index admission, 59 years) patients who were admitted 427 times during the study period were included in the final analysis. The 30-day hospital readmission rate was 46%, with the majority of readmissions attributable to fluid overload (29%), miscellaneous reasons (27%) and infection (20%). One fifth of readmissions were considered preventable. History of variceal haemorrhage was found to be an independent predictor of 30-day hospital readmission. The annual cost of readmission is over AU$2.7 million and the median cost of hospital readmission was about AU$9000.

Conclusions: The 30-day hospital readmission rate of 46% is higher than previously reported and almost half of cases were caused by either fluid overload or infection.

Keywords: cirrhosis; cost analysis; hospital readmission; preventable readmission.

MeSH terms

  • Esophageal and Gastric Varices*
  • Female
  • Gastrointestinal Hemorrhage
  • Humans
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / surgery
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Patient Readmission
  • Retrospective Studies
  • Risk Factors
  • Victoria / epidemiology