{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:12:04Z","timestamp":1790255524727,"version":"4.1.0"},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_med-2026-1488_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate pooled readmission rates among adults with cirrhosis at 30\u00a0days, 90\u00a0days and 1\u00a0year after index hospitalization, and to describe the prevalence of major cirrhosis-related complications among 30-day readmitted patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1488_abs_003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PubMed, Embase, Web of Science and the Cochrane Library were searched from inception to February 7, 2025 without language restrictions. Readmission was defined as rehospitalization after discharge from an index hospitalization, using the definition and ascertainment window reported by each included study. Pooled proportions were estimated using a random-effects model with Freeman-Tukey double-arcsine transformation. Heterogeneity was assessed using the Chi-square test and I\n                      <jats:sup>2<\/jats:sup>\n                      statistic. Sensitivity analyses were conducted, and small-study effects were explored using funnel plots and Egger\u2019s test when sufficient studies were available.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1488_abs_004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen cohort studies involving 316,705 patients with cirrhosis were included. The studies were published from 2015 to 2022 and sample sizes ranged from 111 to 134,038 patients. Nine studies reported 30-day readmission rates ranging from 15\u202f% to 46\u202f%, with a pooled estimate of 27\u202f% (95\u202f% CI: 20\u201335\u202f%; I\n                      <jats:sup>2<\/jats:sup>\n                      =100.0\u202f%, heterogeneity p&lt;0.001). Five studies reported 90-day readmission rates ranging from 25\u202f% to 53\u202f%, with a pooled estimate of 34\u202f% (95\u202f% CI: 29\u201340\u202f%; I\n                      <jats:sup>2<\/jats:sup>\n                      =99.6\u202f%, heterogeneity p&lt;0.001). Two studies reported 1-year readmission, with an exploratory pooled estimate of 33\u202f% (95\u202f% CI: 26\u201339\u202f%; I\n                      <jats:sup>2<\/jats:sup>\n                      =97.7\u202f%, heterogeneity p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2026-1488_abs_005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Readmission after hospitalization for cirrhosis is common across short- and longer-term follow-up windows. However, the pooled estimates should be interpreted cautiously because heterogeneity was extreme, definitions varied across studies, and the 1-year estimate was based on only two studies. Ascites was the most frequently reported complication among 30-day readmitted patients, but the available data do not establish that ascites independently increases readmission\u00a0risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/med-2026-1488","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:58:12Z","timestamp":1790254692000},"source":"Crossref","is-referenced-by-count":0,"title":["Readmission rates among patients with cirrhosis across different follow-up periods and prevalence of major complications: a systematic review and meta-analysis"],"prefix":"10.1515","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7608-6010","authenticated-orcid":false,"given":"Ruiyu","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Gastroenterology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5390-6233","authenticated-orcid":false,"given":"Xiaotong","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Hematology , Hebei Key Laboratory of Hematology, The Second Hospital of Hebei Medical University , Shijiazhuang , Hebei , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8726-5638","authenticated-orcid":false,"given":"Minghui","family":"Wang","sequence":"additional","affiliation":[{"name":"Fengtai 12th Retired Cadres Sanatorium Clinic, Beijing Municipal Bureau of Retired Cadre Service , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"2026092412580636573_j_med-2026-1488_ref_001","doi-asserted-by":"crossref","unstructured":"D\u2019Amico, G, Bernardi, M, Angeli, P. Towards a new definition of decompensated cirrhosis. J\u00a0Hepatol 2022;76:202\u20137.","DOI":"10.1016\/j.jhep.2021.06.018"},{"key":"2026092412580636573_j_med-2026-1488_ref_002","doi-asserted-by":"crossref","unstructured":"Yoshiji, H, Nagoshi, S, Akahane, T, Asaoka, Y, Ueno, Y, Ogawa, K, et al.. Evidence-based clinical practice guidelines for Liver Cirrhosis 2020. J\u00a0Gastroenterol 2021;56:593\u2013619.","DOI":"10.1007\/s00535-021-01788-x"},{"key":"2026092412580636573_j_med-2026-1488_ref_003","doi-asserted-by":"crossref","unstructured":"Asrani, SK, Devarbhavi, H, Eaton, J, Kamath, PS. Burden of liver diseases in the world. J\u00a0Hepatol 2019;70:151\u201371. https:\/\/doi.org\/10.1016\/j.jhep.2018.09.014.","DOI":"10.1016\/j.jhep.2018.09.014"},{"key":"2026092412580636573_j_med-2026-1488_ref_004","doi-asserted-by":"crossref","unstructured":"Alberts, CJ, Clifford, GM, Georges, D, Negro, F, Lesi, OA, Hutin, YJ, et al.. Worldwide prevalence of hepatitis B virus and hepatitis C virus among patients with cirrhosis at country, region, and global levels: a systematic review. Lancet Gastroenterol Hepatol 2022;7:724\u201335. https:\/\/doi.org\/10.1016\/s2468-1253(22)00050-4.","DOI":"10.1016\/S2468-1253(22)00050-4"},{"key":"2026092412580636573_j_med-2026-1488_ref_005","doi-asserted-by":"crossref","unstructured":"Fang, K, Yang, Q, Lin, Y, Zheng, L, Wang, HL, Wu, J. Global cirrhosis prevalence trends and attributable risk factors-an ecological study using data from 1990-2019. Liver Int 2022;42:2791\u20139. https:\/\/doi.org\/10.1111\/liv.15421.","DOI":"10.1111\/liv.15421"},{"key":"2026092412580636573_j_med-2026-1488_ref_006","doi-asserted-by":"crossref","unstructured":"Gines, P, Krag, A, Abraldes, JG, Sola, E, Fabrellas, N, Kamath, PS. Liver cirrhosis. Lancet 2021;398:1359\u201376. https:\/\/doi.org\/10.1016\/s0140-6736(21)01374-x.","DOI":"10.1016\/S0140-6736(21)01374-X"},{"key":"2026092412580636573_j_med-2026-1488_ref_007","doi-asserted-by":"crossref","unstructured":"Jepsen, P, Younossi, ZM. The global burden of cirrhosis: a review of disability-adjusted life-years lost and unmet needs. J\u00a0Hepatol 2021;75:S3\u201313. https:\/\/doi.org\/10.1016\/j.jhep.2020.11.042.","DOI":"10.1016\/j.jhep.2020.11.042"},{"key":"2026092412580636573_j_med-2026-1488_ref_008","doi-asserted-by":"crossref","unstructured":"Peery, AF, Crockett, SD, Murphy, CC, Lund, JL, Dellon, ES, Williams, JL, et al.. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United\u00a0States: update 2018. Gastroenterology 2019;156:254\u201372.e11. https:\/\/doi.org\/10.1053\/j.gastro.2018.08.063.","DOI":"10.1053\/j.gastro.2018.08.063"},{"key":"2026092412580636573_j_med-2026-1488_ref_009","doi-asserted-by":"crossref","unstructured":"Moon, AM, Singal, AG, Tapper, EB. Contemporary epidemiology of chronic liver disease and cirrhosis. Clin Gastroenterol Hepatol 2020;18:2650\u201366. https:\/\/doi.org\/10.1016\/j.cgh.2019.07.060.","DOI":"10.1016\/j.cgh.2019.07.060"},{"key":"2026092412580636573_j_med-2026-1488_ref_010","doi-asserted-by":"crossref","unstructured":"Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD, et al.. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. https:\/\/doi.org\/10.1136\/bmj.n71.","DOI":"10.1136\/bmj.n71"},{"key":"2026092412580636573_j_med-2026-1488_ref_011","doi-asserted-by":"crossref","unstructured":"Taylor, KS, Mahtani, KR, Aronson, JK. Summarising good practice guidelines for data extraction for systematic reviews and meta-analysis. BMJ Evid Based Med 2021;26:88\u201390. https:\/\/doi.org\/10.1136\/bmjebm-2020-111651.","DOI":"10.1136\/bmjebm-2020-111651"},{"key":"2026092412580636573_j_med-2026-1488_ref_012","doi-asserted-by":"crossref","unstructured":"Lo, CK, Mertz, D, Loeb, M. Newcastle-Ottawa Scale: comparing reviewers\u2019 to authors\u2019 assessments. BMC Med Res Methodol 2014;14:45. https:\/\/doi.org\/10.1186\/1471-2288-14-45.","DOI":"10.1186\/1471-2288-14-45"},{"key":"2026092412580636573_j_med-2026-1488_ref_013","doi-asserted-by":"crossref","unstructured":"Vaz, K, Tan, K, Chew, M, Crawford, J, Ma, R, Grace, J, et al.. Rate of early hospital readmission amongst cirrhotic patients is high in Australia: experience from a single liver transplant centre. Intern Med J 2022;52:2086\u201395. https:\/\/doi.org\/10.1111\/imj.15932.","DOI":"10.1111\/imj.15932"},{"key":"2026092412580636573_j_med-2026-1488_ref_014","doi-asserted-by":"crossref","unstructured":"Singal, AK, DiMartini, A, Leggio, L, Arab, JP, Kuo, YF, Shah, VH. Identifying alcohol use disorder in patients with cirrhosis reduces 30-days readmission rate. Alcohol Alcohol 2022;57:576\u201380. https:\/\/doi.org\/10.1093\/alcalc\/agac015.","DOI":"10.1093\/alcalc\/agac015"},{"key":"2026092412580636573_j_med-2026-1488_ref_015","doi-asserted-by":"crossref","unstructured":"Gajendran, M, Umapathy, C, Perisetti, A, Loganathan, P, Dwivedi, A, Alvarado, LA, et al.. Nationwide analysis of incidence and predictors of 30-day readmissions in patients with decompensated cirrhosis. Frontline Gastroenterol 2022;13:295\u2013302. https:\/\/doi.org\/10.1136\/flgastro-2021-101850.","DOI":"10.1136\/flgastro-2021-101850"},{"key":"2026092412580636573_j_med-2026-1488_ref_016","doi-asserted-by":"crossref","unstructured":"Bajaj, JS, Garcia-Tsao, G, Wong, F, Biggins, SW, Kamath, PS, McGeorge, S, et al.. Cirrhosis is associated with high mortality and readmissions over 90\u00a0days regardless of COVID-19: a multicenter cohort. Liver Transpl 2021;27:1343\u20137. https:\/\/doi.org\/10.1002\/lt.25981.","DOI":"10.1002\/lt.25981"},{"key":"2026092412580636573_j_med-2026-1488_ref_017","doi-asserted-by":"crossref","unstructured":"Jain, P, Shasthry, SM, Choudhury, AK, Maiwall, R, Kumar, G, Bharadwaj, A, et al.. Alcohol-associated liver cirrhotics have higher mortality after index hospitalization: long-term data of 5,138 patients. Clin Mol Hepatol 2021;27:175\u201385. https:\/\/doi.org\/10.3350\/cmh.2020.0068.","DOI":"10.3350\/cmh.2020.0068"},{"key":"2026092412580636573_j_med-2026-1488_ref_018","doi-asserted-by":"crossref","unstructured":"Chirapongsathorn, S, Poovorawan, K, Soonthornworasiri, N, Pan-ngum, W, Phaosawasdi, K, Treeprasertsuk, S. Thirty-day readmission and cost analysis in patients with cirrhosis: a nationwide population-based data. Hepatol Commun 2020;4:453\u201360. https:\/\/doi.org\/10.1002\/hep4.1472.","DOI":"10.1002\/hep4.1472"},{"key":"2026092412580636573_j_med-2026-1488_ref_019","doi-asserted-by":"crossref","unstructured":"Shaheen, AA, Nguyen, HH, Congly, SE, Kaplan, GG, Swain, MG. Nationwide estimates and risk factors of hospital readmission in patients with cirrhosis in the United\u00a0States. Liver Int 2019;39:878\u201384. https:\/\/doi.org\/10.1111\/liv.14054.","DOI":"10.1111\/liv.14054"},{"key":"2026092412580636573_j_med-2026-1488_ref_020","doi-asserted-by":"crossref","unstructured":"Mukthinuthalapati, VVPK, Akinyeye, S, Fricker, ZP, Syed, M, Orman, ES, Nephew, L, et al.. Early predictors of outcomes of hospitalization for cirrhosis and assessment of the impact of race and ethnicity at safety-net hospitals. PLoS One 2019;14:e0211811. https:\/\/doi.org\/10.1371\/journal.pone.0211811.","DOI":"10.1371\/journal.pone.0211811"},{"key":"2026092412580636573_j_med-2026-1488_ref_021","doi-asserted-by":"crossref","unstructured":"Dai, JY, Zhao, J, Du, Y, McNeil, EB, Chongsuvivatwong, V. Biomarkers and sociodemographic factors predicting one-year readmission among liver cirrhosis patients. Ther Clin Risk Manag 2019;15:979\u201389. https:\/\/doi.org\/10.2147\/TCRM.S203883.","DOI":"10.2147\/TCRM.S203883"},{"key":"2026092412580636573_j_med-2026-1488_ref_022","doi-asserted-by":"crossref","unstructured":"Chirapongsathorn, S, Krittanawong, C, Enders, FT, Pendegraft, R, Mara, KC, Borah, BJ, et al.. Incidence and cost analysis of hospital admission and 30-day readmission among patients with cirrhosis. Hepatol Commun 2018;2:188\u201398. https:\/\/doi.org\/10.1002\/hep4.1137.","DOI":"10.1002\/hep4.1137"},{"key":"2026092412580636573_j_med-2026-1488_ref_023","doi-asserted-by":"crossref","unstructured":"Seraj, SM, Campbell, EJ, Argyropoulos, SK, Wegermann, K, Chung, RT, Richter, JM. Hospital readmissions in decompensated cirrhotics: factors pointing toward a prevention strategy. World J Gastroenterol 2017;23:6868\u201376. https:\/\/doi.org\/10.3748\/wjg.v23.i37.6868.","DOI":"10.3748\/wjg.v23.i37.6868"},{"key":"2026092412580636573_j_med-2026-1488_ref_024","doi-asserted-by":"crossref","unstructured":"Bajaj, JS, Reddy, KR, Tandon, P, Wong, F, Kamath, PS, Garcia-Tsao, G, et al.. The 3-month readmission rate remains unacceptably high in a large North American cohort of patients with cirrhosis. Hepatology 2016;64:200\u20138. https:\/\/doi.org\/10.1002\/hep.28414.","DOI":"10.1002\/hep.28414"},{"key":"2026092412580636573_j_med-2026-1488_ref_025","doi-asserted-by":"crossref","unstructured":"Agrawal, K, Kumar, P, Markert, R, Agrawal, S. Risk factors for 30-day readmissions of individuals with decompensated cirrhosis. South Med J 2015;108:682\u20137. https:\/\/doi.org\/10.14423\/SMJ.0000000000000371.","DOI":"10.14423\/SMJ.0000000000000371"},{"key":"2026092412580636573_j_med-2026-1488_ref_033","doi-asserted-by":"crossref","unstructured":"Patel, H, Balar, B, Irigela, M, Vootla, V, Chandrala, C, Hashmi, H, et al.. Risk factors for liver cirrhosis-related readmissions in the largest ethnic minority in United States. Gastroenterol Res 2020;13:11\u20138. https:\/\/doi.org\/10.14740\/gr1227.","DOI":"10.14740\/gr1227"},{"key":"2026092412580636573_j_med-2026-1488_ref_026","doi-asserted-by":"crossref","unstructured":"Orman, ES, Ghabril, M, Emmett, TW, Chalasani, N. Hospital readmissions in patients with cirrhosis: a systematic review. J\u00a0Hosp Med 2018;13:490\u20135. https:\/\/doi.org\/10.12788\/jhm.2967.","DOI":"10.12788\/jhm.2967"},{"key":"2026092412580636573_j_med-2026-1488_ref_027","doi-asserted-by":"crossref","unstructured":"Garg, SK, Goyal, H, Obaitan, I, Shah, PA, Sarvepalli, S, Jophlin, LL, et al.. Incidence and predictors of 30-day hospital readmissions for liver cirrhosis: insights from the United\u00a0States National Readmissions Database. Ann Transl Med 2021;9:1052. https:\/\/doi.org\/10.21037\/atm-20-1762.","DOI":"10.21037\/atm-20-1762"},{"key":"2026092412580636573_j_med-2026-1488_ref_028","doi-asserted-by":"crossref","unstructured":"Benmassaoud, A, Freeman, SC, Roccarina, D, Plaz Torres, MC, Sutton, AJ, Cooper, NJ, et al.. Treatment for ascites in adults with decompensated liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev 2020;2020:CD013123. https:\/\/doi.org\/10.1002\/14651858.CD013123.pub2.","DOI":"10.1002\/14651858.CD013123.pub2"},{"key":"2026092412580636573_j_med-2026-1488_ref_029","doi-asserted-by":"crossref","unstructured":"Hou, W, Sanyal, AJ. Ascites: diagnosis and management. Med Clin North Am 2009;93:801\u201317. https:\/\/doi.org\/10.1016\/j.mcna.2009.03.007.","DOI":"10.1016\/j.mcna.2009.03.007"},{"key":"2026092412580636573_j_med-2026-1488_ref_030","doi-asserted-by":"crossref","unstructured":"Garcia-Pagan, JC, Francoz, C, Montagnese, S, Senzolo, M, Mookerjee, RP. Management of the major complications of cirrhosis: beyond guidelines. J\u00a0Hepatol 2021;75:S135\u201346. https:\/\/doi.org\/10.1016\/j.jhep.2021.01.027.","DOI":"10.1016\/j.jhep.2021.01.027"},{"key":"2026092412580636573_j_med-2026-1488_ref_031","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver. EASL Clinical Practice Guidelines on nutrition in chronic liver disease. J\u00a0Hepatol 2019;70:172\u201393. https:\/\/doi.org\/10.1016\/j.jhep.2018.06.024.","DOI":"10.1016\/j.jhep.2018.06.024"},{"key":"2026092412580636573_j_med-2026-1488_ref_032","doi-asserted-by":"crossref","unstructured":"Lai, JC, Tandon, P, Bernal, W, Tapper, EB, Ekong, U, Dasarathy, S, et al.. Malnutrition, frailty, and sarcopenia in patients with cirrhosis: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology 2021;74:1611\u201344. https:\/\/doi.org\/10.1002\/hep.32049.","DOI":"10.1002\/hep.32049"}],"container-title":["Open Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2026-1488\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2026-1488\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:58:25Z","timestamp":1790254705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2026-1488\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,9,23]]},"published-print":{"date-parts":[[2026,1,23]]}},"alternative-id":["10.1515\/med-2026-1488"],"URL":"https:\/\/doi.org\/10.1515\/med-2026-1488","relation":{},"ISSN":["2391-5463"],"issn-type":[{"value":"2391-5463","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]},"article-number":"20261488"}}