{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:29:09Z","timestamp":1787236149396,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.81870425"],"award-info":[{"award-number":["No.81870425"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Health Science and Technology Project of Zhejiang Provincial Health Commission","award":["No.2022RC141"],"award-info":[{"award-number":["No.2022RC141"]}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["No.226-2023-00127 and 2021FZZX001-41"],"award-info":[{"award-number":["No.226-2023-00127 and 2021FZZX001-41"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["No.2022YFC2304501 and 2021YFC2301800"],"award-info":[{"award-number":["No.2022YFC2304501 and 2021YFC2301800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver diseases were significant source of early readmission burden. This study aimed to evaluate the 30-day unplanned readmission rates, causes of readmissions, readmission costs, and predictors of readmission in patients with acute liver failure (ALF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients admitted for ALF from 2019 National Readmission Database were enrolled. Weighted multivariable logistic regression models were applied and based on Directed Acyclic Graphs. Incidence, causes, cost, and predictors of 30-day unplanned readmissions were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3,281 patients with ALF were enrolled, of whom 600 (18.3%) were readmitted within 30 days. The mean time from discharge to early readmission was 12.6 days. The average hospital cost and charge of readmission were $19,629 and $86,228, respectively. The readmissions were mainly due to liver-related events (26.6%), followed by infection (20.9%). The predictive factors independently associated with readmissions were age, male sex (OR 1.227, 95% CI 1.023\u20131.472;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.028), renal failure (OR 1.401, 95% CI 1.139\u20131.723;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), diabetes with chronic complications (OR 1.327, 95% CI 1.053\u20131.672;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017), complicated hypertension (OR 1.436, 95% CI 1.111\u20131.857;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), peritoneal drainage (OR 1.600, 95% CI 1.092\u20132.345;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016), etc.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with ALF are at relatively high risk of early readmission, which imposes a heavy medical and economic burden on society. We need to increase the emphasis placed on early readmission of patients with ALF and establish clinical strategies for their management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-024-03249-0","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T07:01:54Z","timestamp":1714719714000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The burden and predictors of 30-day unplanned readmission in patients with acute liver failure: a national representative database study"],"prefix":"10.1186","volume":"24","author":[{"given":"Xianbin","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huilan","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoheng","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoda","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jifang","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"issue":"10201","key":"3249_CR1","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1016\/S0140-6736(19)31894-X","volume":"394","author":"RT Stravitz","year":"2019","unstructured":"Stravitz RT, Lee WM. Acute liver failure. Lancet. 2019;394(10201):869\u201381.","journal-title":"Lancet"},{"issue":"8866","key":"3249_CR2","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/0140-6736(93)91809-Z","volume":"342","author":"J Bernuau","year":"1993","unstructured":"Bernuau J, Benhamou JP. Classifying acute liver failure. Lancet. 1993;342(8866):252\u20133.","journal-title":"Lancet"},{"issue":"2","key":"3249_CR3","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1056\/NEJMc1614962","volume":"376","author":"A Borkakoty","year":"2017","unstructured":"Borkakoty A, Kumar P, Taneja S. Hepatic Encephalopathy. N Engl J Med. 2017;376(2):186.","journal-title":"N Engl J Med"},{"issue":"2","key":"3249_CR4","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1053\/j.gastro.2021.10.017","volume":"162","author":"AF Peery","year":"2022","unstructured":"Peery AF, Crockett SD, Murphy CC, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2021. Gastroenterology. 2022;162(2):621\u201344.","journal-title":"Gastroenterology"},{"issue":"2","key":"3249_CR5","doi-asserted-by":"publisher","first-page":"141","DOI":"10.4240\/wjgs.v13.i2.141","volume":"13","author":"SG Krishna","year":"2021","unstructured":"Krishna SG, Chu BK, Blaszczak AM, et al. Hospital outcomes and early readmission for the most common gastrointestinal and liver diseases in the United States: implications for healthcare delivery. World J Gastrointest Surg. 2021;13(2):141\u201352.","journal-title":"World J Gastrointest Surg"},{"issue":"1","key":"3249_CR6","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1053\/j.gastro.2018.08.063","volume":"156","author":"AF Peery","year":"2019","unstructured":"Peery AF, Crockett SD, Murphy CC, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2018. Gastroenterology. 2019;156(1):254\u2013e27211.","journal-title":"Gastroenterology"},{"issue":"13","key":"3249_CR7","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.21037\/atm-20-1762","volume":"9","author":"SK Garg","year":"2021","unstructured":"Garg SK, Goyal H, Obaitan I, et al. Incidence and predictors of 30-day hospital readmissions for liver cirrhosis: insights from the United States National readmissions Database. Ann Transl Med. 2021;9(13):1052\u20131052.","journal-title":"Ann Transl Med"},{"issue":"2","key":"3249_CR8","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1002\/hep4.1137","volume":"2","author":"S Chirapongsathorn","year":"2018","unstructured":"Chirapongsathorn S, Krittanawong C, Enders FT, et al. Incidence and cost analysis of hospital admission and 30-day readmission among patients with cirrhosis. Hepatol Commun. 2018;2(2):188\u201398.","journal-title":"Hepatol Commun"},{"issue":"2","key":"3249_CR9","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1002\/hep.30274","volume":"70","author":"K Mumtaz","year":"2019","unstructured":"Mumtaz K, Issak A, Porter K, et al. Validation of risk score in Predicting Early readmissions in Decompensated Cirrhotic patients: a Model based on the administrative database. Hepatology. 2019;70(2):630\u20139.","journal-title":"Hepatology"},{"key":"3249_CR10","unstructured":"HCUP Nationwide Readmissions Database (NRD). Healthcare Cost and Utilization Project (HCUP). 2014, 2016, and 2017. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov\/nrdoverview.jsp. Accessed October 1, 2022."},{"issue":"4","key":"3249_CR11","first-page":"43","volume":"117","author":"N Weiler","year":"2020","unstructured":"Weiler N, Schlotmann A, Schnitzbauer AA, et al. The epidemiology of Acute Liver failure. Dtsch Arztebl Int. 2020;117(4):43\u201350.","journal-title":"Dtsch Arztebl Int"},{"key":"3249_CR12","unstructured":"HCUP Clinical Classifications Software Refined (CCSR). for ICD-10-CM diagnoses, v2021.2. Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov\/toolssoftware\/ccsr\/dxccsr.jsp. Accessed October 1, 2022."},{"key":"3249_CR13","unstructured":"HCUP Cost-to-Charge Ratio (CCR) for the Nationwide Readmissions Database (NRD). Healthcare Cost and Utilization Project (HCUP). 2019. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov\/db\/ccr\/ip-ccr\/ip-ccr.jsp. Accessed October 1, 2022."},{"issue":"14","key":"3249_CR14","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.1056\/NEJMsa0803563","volume":"360","author":"SF Jencks","year":"2009","unstructured":"Jencks SF, Williams Mv, Coleman EA. Rehospitalizations among patients in the Medicare Fee-for-Service Program. N Engl J Med. 2009;360(14):1418\u201328.","journal-title":"N Engl J Med"},{"issue":"16","key":"3249_CR15","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1056\/NEJMsa1513024","volume":"374","author":"RB Zuckerman","year":"2016","unstructured":"Zuckerman RB, Sheingold SH, Orav EJ, Ruhter J, Epstein AM. Readmissions, Observation, and the Hospital readmissions Reduction Program. N Engl J Med. 2016;374(16):1543\u201351.","journal-title":"N Engl J Med"},{"key":"3249_CR16","doi-asserted-by":"crossref","unstructured":"Berry JG, Gay JC, Joynt Maddox K et al. Age trends in 30\u00a0day hospital readmissions: US national retrospective analysis. BMJ. 2018;360.","DOI":"10.1136\/bmj.k497"},{"issue":"11","key":"3249_CR17","doi-asserted-by":"publisher","first-page":"1950","DOI":"10.1016\/j.cgh.2014.05.008","volume":"12","author":"N Dharel","year":"2014","unstructured":"Dharel N, Bajaj JS. Antibiotic prophylaxis in acute liver failure: friend or foe? Clin Gastroenterol Hepatol. 2014;12(11):1950\u20132.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"3249_CR18","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1002\/hep.21240","volume":"44","author":"CG Antoniades","year":"2006","unstructured":"Antoniades CG, Berry PA, Davies ET, et al. Reduced monocyte HLA-DR expression: a novel biomarker of disease severity and outcome in acetaminophen-induced acute liver failure. Hepatology. 2006;44(1):34\u201343.","journal-title":"Hepatology"},{"issue":"8","key":"3249_CR19","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1136\/gut.21.8.643","volume":"21","author":"RJ Wyke","year":"1980","unstructured":"Wyke RJ, Rajkovic I, Eddleston ALWF, Williams R. Defective opsonisation and complement deficiency in serum from patients with fulminant hepatic failure. Gut. 1980;21(8):643\u20139.","journal-title":"Gut"},{"issue":"3","key":"3249_CR20","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1053\/j.gastro.2011.11.027","volume":"142","author":"V Garg","year":"2012","unstructured":"Garg V, Garg H, Khan A, et al. Granulocyte colony-stimulating factor mobilizes CD34(+) cells and improves survival of patients with acute-on-chronic liver failure. Gastroenterology. 2012;142(3):505\u2013e5121.","journal-title":"Gastroenterology"},{"issue":"11","key":"3249_CR21","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.1097\/01.CCM.0000287592.94554.5F","volume":"35","author":"RT Stravitz","year":"2007","unstructured":"Stravitz RT, Kramer AH, Davern T, et al. Intensive care of patients with acute liver failure: recommendations of the U.S. Acute Liver failure Study Group. Crit Care Med. 2007;35(11):2498\u2013508.","journal-title":"Crit Care Med"},{"issue":"11","key":"3249_CR22","doi-asserted-by":"publisher","first-page":"1942","DOI":"10.1016\/j.cgh.2014.03.011","volume":"12","author":"K CJ","year":"2014","unstructured":"CJ K. Effects of antimicrobial prophylaxis and blood stream infections in patients with acute liver failure: a retrospective cohort study. Clin Gastroenterol Hepatol. 2014;12(11):1942\u2013e19491.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"3249_CR23","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.cgh.2010.10.035","volume":"9","author":"K Berman","year":"2011","unstructured":"Berman K, Tandra S, Forssell K, et al. Incidence and predictors of 30-day readmission among patients hospitalized for advanced liver disease. Clin Gastroenterol Hepatol. 2011;9(3):254\u20139.","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"5","key":"3249_CR24","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/j.jhep.2016.12.003","volume":"66","author":"J Wendon","year":"2017","unstructured":"Wendon J. EASL Clinical practical guidelines on the management of acute (fulminant) liver failure. J Hepatol. 2017;66(5):1047\u201381.","journal-title":"J Hepatol"},{"issue":"2","key":"3249_CR25","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.cgh.2014.07.011","volume":"13","author":"SR Tujios","year":"2015","unstructured":"Tujios SR, Hynan LS, Vazquez MA, et al. Risk factors and outcomes of acute kidney injury in patients with acute liver failure. Clin Gastroenterol Hepatol. 2015;13(2):352\u20139.","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03249-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-024-03249-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03249-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T07:02:34Z","timestamp":1714719754000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-024-03249-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,3]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3249"],"URL":"https:\/\/doi.org\/10.1186\/s12876-024-03249-0","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,3]]},"assertion":[{"value":"10 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"153"}}