Pattern of Readmission of Patients with Decompensated Cirrhosis in a Tertiary Care Hospital

Madhusudan Saha1, Mohammad Zakaria2, Md Anisur Rahman3, Tarequl Islam Shawrab4, Habib Ullah Abir5, Lovely Roy Bristi6 , Tafhim Ahmed Rifat7 1. Professor, Department of Gastroenterology, North East Medical College, South Surma, Sylhet, Bangladesh . 2. Indoor Medical Officer, North East Medical College, South Surma, Sylhet, Bangladesh 3. Assistant Professor, Department of Medicine, North East Medical College, South Surma, Sylhet, Bangladesh 4. Intern Doctor, North East Medical College, South Surma, Sylhet, Bangladesh 5. Intern Doctor, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh 6. Assistant Professor, Department of Community Medicine, Sylhet Womens Medical College, Sylhet Abstract Introduction: This study was designed to see the incidence and cause of readmission of patients with decompensated cirrhosis. Material and methods: Consecutive patients with decompensated cirrhosis admitted under gastroenterology unit were included. Demographic information, clinical and laboratory data at every admission were recorded for a definite period, then statistical analysis was done to see incidence and aetiology and associated factors of readmission. Result: Total 37 (41.11%) out of 90 patients were readmitted from January 2015 to December 2018 and their total number of admission was 113. Age of them varied from 22-95 years (mean 53.64). Among them 21 (56.8%) and 16 (43.2%) were female and male respectively. Thirty one (83.8%) and six (16.2%) were readmitted within 30 days and 90 day of index hospitalisation respectively. Hepatitis B virus and hepatitis C virus were the aetiology in 23 (63.9%) and 6(16.7%) cases respectively. Commonest cause of readmission was ascites (N 64:56.64%) followed by hepatic encephalopathy (N 31; 27.43%). All patients had hypoalbunaemia. Readmission was higher among patients of age above 45 years (22, 59.5%). Readmission was also higher among females (21, 56.8%). Conclusion: Readmission of patients with decompensated cirrhosis is common. Ascites and encephalopathy are commonest cause of readmission. Older age, female sex, hypoalbuminaemia and hyponatremia are associated factors for readmission. Key Words: Hospital readmission, Decompensated Cirrhosis Corresponding author: Madhusudan Saha, Professor, Gastroenterology, North East Medical College, South Surma, Sylhet, Bangladesh