Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018
Background: Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. The 5-year survival rate for liver cancer in the US has improved from 3% four decades ago to 20% now. Transarterial chemoembolization (TACE) is the treatment of choice for stage B/intermediate-stage HCC....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Gastroenterology Insights |
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| Online Access: | https://www.mdpi.com/2036-7422/15/1/6 |
| _version_ | 1797240971538202624 |
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| author | Ifrah Fatima Mohamed Ahmed Wael T. Mohamed Vinay Jahagirdar Kevin F. Kennedy Alisa Likhitsup |
| author_facet | Ifrah Fatima Mohamed Ahmed Wael T. Mohamed Vinay Jahagirdar Kevin F. Kennedy Alisa Likhitsup |
| author_sort | Ifrah Fatima |
| collection | DOAJ |
| description | Background: Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. The 5-year survival rate for liver cancer in the US has improved from 3% four decades ago to 20% now. Transarterial chemoembolization (TACE) is the treatment of choice for stage B/intermediate-stage HCC. Complications of TACE include hepatic encephalopathy, liver failure, post-embolization syndrome, duodenal ulcers, liver abscesses, acute cholecystitis, and injury to the biliary tract. This study evaluates the 30-day readmission rate and predictors of readmission among patients with HCC undergoing TACE. Methods: The 2016–2018 Healthcare Cost and Utilization Project (HCUP) database, which includes the National Readmission Database (NRD), was used. All adult patients with HCC who underwent TACE were identified using the International Classification of Diseases (ICD-10). The rate of 30-day readmissions after TACE and the associated diagnoses were identified. Logistic regression was used to obtain adjusted odds ratios for variables associated with 30-day readmission. Results: A total of 566 patients underwent TACE between 2016–2018. Sixty-five patients were excluded due to death and unavailability of 30-day readmission data. The procedure was performed in large (80.4%), metro-teaching hospitals (94.5%). Mean patient age was 65.1 ± 9.9 years, and 74% of patients were male. Among the 501 patients, 81 (16.2%) were readmitted within 30 days. The mean age for readmitted patients was 63.2 ± 11.0 and 69.1% were male. The mean length of stay at readmission was 5.5 ± 7.3 days. A total of 7.4% of patients had neurological disorders, 17.3% had weight loss, 30.9% had fluid and electrolyte imbalance, and 21.0% had hepatic encephalopathy. The most common primary diagnoses at 30-day readmission were liver cell carcinoma, sepsis, and liver failure. Univariate analysis for variables associated with 30-day readmission included hepatic encephalopathy (OR 3.45; 95% CI 1.8–6.62; <i>p</i> = 0.0002), underlying neurological disorders (OR 3.28; 95% CI 1.16–9.3; <i>p</i> = 0.03), weight loss (OR 2.82; 95% CI 1.42–5.61; <i>p</i> = 0.003), and Medicaid status (OR 1.74; 95% CI 1.05–2.88; <i>p</i> = 0.03). Multivariable analysis showed hepatic encephalopathy (OR 2.91; 95% CI 1.4, 6.04; <i>p</i> = 0.04) and weight loss (OR 2.37; 95% CI 1.13–4.96; <i>p</i> = 0.02) were associated with hospital readmission. Conclusions: Weight loss and hepatic encephalopathy were predictors for 30-day readmission after a TACE procedure for HCC. |
| first_indexed | 2024-04-24T18:15:54Z |
| format | Article |
| id | doaj.art-8691987883f9410eb4e518c509e39225 |
| institution | Directory Open Access Journal |
| issn | 2036-7414 2036-7422 |
| language | English |
| last_indexed | 2024-04-24T18:15:54Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastroenterology Insights |
| spelling | doaj.art-8691987883f9410eb4e518c509e392252024-03-27T13:42:27ZengMDPI AGGastroenterology Insights2036-74142036-74222024-01-01151879710.3390/gastroent15010006Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018Ifrah Fatima0Mohamed Ahmed1Wael T. Mohamed2Vinay Jahagirdar3Kevin F. Kennedy4Alisa Likhitsup5Department of Internal Medicine, University Health Truman Medical Center, University of Missouri, 2301 Holmes Street, Kansas City, MO 64108, USADepartment of Internal Medicine, University Health Truman Medical Center, University of Missouri, 2301 Holmes Street, Kansas City, MO 64108, USADepartment of Internal Medicine, University Health Truman Medical Center, University of Missouri, 2301 Holmes Street, Kansas City, MO 64108, USADepartment of Internal Medicine, University Health Truman Medical Center, University of Missouri, 2301 Holmes Street, Kansas City, MO 64108, USADepartment of Cardiovascular Research, Saint Luke’s Hospital, Kansas City, MO 64111, USADepartment of Gastroenterology, University of Missouri, Kansas City, MO 64111, USABackground: Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. The 5-year survival rate for liver cancer in the US has improved from 3% four decades ago to 20% now. Transarterial chemoembolization (TACE) is the treatment of choice for stage B/intermediate-stage HCC. Complications of TACE include hepatic encephalopathy, liver failure, post-embolization syndrome, duodenal ulcers, liver abscesses, acute cholecystitis, and injury to the biliary tract. This study evaluates the 30-day readmission rate and predictors of readmission among patients with HCC undergoing TACE. Methods: The 2016–2018 Healthcare Cost and Utilization Project (HCUP) database, which includes the National Readmission Database (NRD), was used. All adult patients with HCC who underwent TACE were identified using the International Classification of Diseases (ICD-10). The rate of 30-day readmissions after TACE and the associated diagnoses were identified. Logistic regression was used to obtain adjusted odds ratios for variables associated with 30-day readmission. Results: A total of 566 patients underwent TACE between 2016–2018. Sixty-five patients were excluded due to death and unavailability of 30-day readmission data. The procedure was performed in large (80.4%), metro-teaching hospitals (94.5%). Mean patient age was 65.1 ± 9.9 years, and 74% of patients were male. Among the 501 patients, 81 (16.2%) were readmitted within 30 days. The mean age for readmitted patients was 63.2 ± 11.0 and 69.1% were male. The mean length of stay at readmission was 5.5 ± 7.3 days. A total of 7.4% of patients had neurological disorders, 17.3% had weight loss, 30.9% had fluid and electrolyte imbalance, and 21.0% had hepatic encephalopathy. The most common primary diagnoses at 30-day readmission were liver cell carcinoma, sepsis, and liver failure. Univariate analysis for variables associated with 30-day readmission included hepatic encephalopathy (OR 3.45; 95% CI 1.8–6.62; <i>p</i> = 0.0002), underlying neurological disorders (OR 3.28; 95% CI 1.16–9.3; <i>p</i> = 0.03), weight loss (OR 2.82; 95% CI 1.42–5.61; <i>p</i> = 0.003), and Medicaid status (OR 1.74; 95% CI 1.05–2.88; <i>p</i> = 0.03). Multivariable analysis showed hepatic encephalopathy (OR 2.91; 95% CI 1.4, 6.04; <i>p</i> = 0.04) and weight loss (OR 2.37; 95% CI 1.13–4.96; <i>p</i> = 0.02) were associated with hospital readmission. Conclusions: Weight loss and hepatic encephalopathy were predictors for 30-day readmission after a TACE procedure for HCC.https://www.mdpi.com/2036-7422/15/1/6transarterial chemoembolizationhepatocellular carcinomareadmissionhepatic encephalopathyweight losscirrhosis |
| spellingShingle | Ifrah Fatima Mohamed Ahmed Wael T. Mohamed Vinay Jahagirdar Kevin F. Kennedy Alisa Likhitsup Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018 Gastroenterology Insights transarterial chemoembolization hepatocellular carcinoma readmission hepatic encephalopathy weight loss cirrhosis |
| title | Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018 |
| title_full | Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018 |
| title_fullStr | Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018 |
| title_full_unstemmed | Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018 |
| title_short | Outcomes and Predictors of 30-Day Readmission in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization between 2016 and 2018 |
| title_sort | outcomes and predictors of 30 day readmission in patients with hepatocellular carcinoma undergoing transarterial chemoembolization between 2016 and 2018 |
| topic | transarterial chemoembolization hepatocellular carcinoma readmission hepatic encephalopathy weight loss cirrhosis |
| url | https://www.mdpi.com/2036-7422/15/1/6 |
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