{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:20:48Z","timestamp":1788211248763,"version":"build-2803163510"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Ascites is associated with substantial symptom burden and increased healthcare utilization, and it is observed in patients with advanced disease across multiple etiologies. However, because ascites is a clinical sign rather than a diagnosis category, it can be challenging to study using routine health reporting. In routinely collected hospital administrative data, ascites is commonly captured using International Classification of Diseases, Tenth Revision (ICD-10) code R18, an etiologically non-specific classification whose outcome implications are less documented. We aimed to evaluate the incremental association of R18-coded ascites with length of stay (LOS), readmission burden, and in-hospital mortality in the Gastroenterology and Internal Medicine inpatient department, beyond comorbidity burden and other coded decompensation proxies. Materials and Methods: We conducted a single-center retrospective study using routinely collected administrative discharge data from adult inpatient admissions (2015\u20132023) in the Gastroenterology and Internal Medicine department of a Romanian tertiary-care hospital. Admissions were classified by the presence of ICD-10 R18-coded ascites. Outcomes were LOS, readmission burden (count of subsequent admissions), and in-hospital mortality. Multivariable models adjusted for age, sex, and comorbidity burden (Charlson Comorbidity Index), with additional models incorporating ICD-10-derived decompensation proxies to assess overlap in administrative severity signal. LOS was further examined within Charlson strata to evaluate incremental stratification. Results: Coded ascites was associated with higher hospital burden, including longer LOS and greater readmission burden, and with higher in-hospital mortality in partially adjusted models. Within each CCI stratum, LOS remained higher among admissions with R18-coded ascites, supporting incremental stratification beyond comorbidity alone. Furthermore, mobility impairment was an important predictor of LOS. Age-stratified analyses suggested a high-burden phenotype among younger patients and infrequent R18 coding among the very elderly in this cohort. Conclusions: These findings support the potential utility of R18-coded ascites as a pragmatic administrative marker for risk adjustment and service planning.<\/jats:p>","DOI":"10.3390\/medicina62040751","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:29:08Z","timestamp":1776162548000},"page":"751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Ascites on Morbidity and Length of Hospital Stay: A Large Retrospective Study from a Tertiary Referral Center"],"prefix":"10.3390","volume":"62","author":[{"given":"Ion Daniel","family":"Baboi","sequence":"first","affiliation":[{"name":"Department of Medical Semiology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Gastroenterology Department, \u201cSf. Ioan\u201d Clinical Emergency Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8888-1936","authenticated-orcid":false,"given":"Maria","family":"Nedelcu","sequence":"additional","affiliation":[{"name":"Department of Medical Semiology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0441-3905","authenticated-orcid":false,"given":"Lavinia Alice","family":"B\u0103l\u0103ceanu","sequence":"additional","affiliation":[{"name":"Department of Medical Semiology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Internal Medicine Department, \u201cSf. Ioan\u201d Clinical Emergency Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Valeria","family":"Grigorescu","sequence":"additional","affiliation":[{"name":"Department of Medical Semiology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Gastroenterology Department, \u201cSf. Ioan\u201d Clinical Emergency Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6704-4890","authenticated-orcid":false,"given":"Ion","family":"Dina","sequence":"additional","affiliation":[{"name":"Department of Medical Semiology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Gastroenterology Department, \u201cSf. Ioan\u201d Clinical Emergency Hospital, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.4254\/wjh.v5.i5.251","article-title":"Cirrhotic Ascites Review: Pathophysiology, Diagnosis and Management","volume":"5","author":"Moore","year":"2013","journal-title":"World J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1002\/hep.1840070124","article-title":"Compensated Cirrhosis: Natural History and Prognostic Factors","volume":"7","author":"Quintero","year":"1987","journal-title":"Hepatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"240","DOI":"10.15403\/jgld-3405","article-title":"Validation and Performance of Chronic Liver Disease Questionnaire (CLDQ-RO) in the Romanian Population","volume":"30","author":"Taru","year":"2021","journal-title":"J. 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