Open medicine (Warsaw, Poland) · 2026
Readmission rates among patients with cirrhosis across different follow-up periods and prevalence of major complications: a systematic review and meta-analysis.
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Xie Ruiyu, Jing Xiaotong, Wang Minghui
Аннотация
OBJECTIVES: To estimate pooled readmission rates among adults with cirrhosis at 30 days, 90 days and 1 year after index hospitalization, and to describe the prevalence of major cirrhosis-related complications among 30-day readmitted patients.
METHODS: 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 I2 statistic. Sensitivity analyses were conducted, and small-study effects were explored using funnel plots and Egger's test when sufficient studies were available.
RESULTS: 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 % to 46 %, with a pooled estimate of 27 % (95 % CI: 20-35 %; I2=100.0 %, heterogeneity p<0.001). Five studies reported 90-day readmission rates ranging from 25 % to 53 %, with a pooled estimate of 34 % (95 % CI: 29-40 %; I2=99.6 %, heterogeneity p<0.001). Two studies reported 1-year readmission, with an exploratory pooled estimate of 33 % (95 % CI: 26-39 %; I2=97.7 %, heterogeneity p<0.001).
CONCLUSIONS: 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 risk.
METHODS: 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 I2 statistic. Sensitivity analyses were conducted, and small-study effects were explored using funnel plots and Egger's test when sufficient studies were available.
RESULTS: 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 % to 46 %, with a pooled estimate of 27 % (95 % CI: 20-35 %; I2=100.0 %, heterogeneity p<0.001). Five studies reported 90-day readmission rates ranging from 25 % to 53 %, with a pooled estimate of 34 % (95 % CI: 29-40 %; I2=99.6 %, heterogeneity p<0.001). Two studies reported 1-year readmission, with an exploratory pooled estimate of 33 % (95 % CI: 26-39 %; I2=97.7 %, heterogeneity p<0.001).
CONCLUSIONS: 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 risk.