Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 15, Number 5, October 2022, pages 253-262

Rates, Reasons, and Independent Predictors of Readmissions in Portal Venous Thrombosis Hospitalizations in the USA

Figure 1. Predictors of 30-day all-cause readmissions of PVT, showing the adjusted hazard ratio with their confidence intervals for the predictors of 30-day all-cause readmissions for PVT hospitalizations. PVT: portal vein thrombosis.

Figure 2. Kaplan-Meier graph for 30-day all-cause readmissions of PVT hospitalizations by sex, showing almost similar distribution by sex in the Kaplan-Meier curve for 30-day readmissions in PVT hospitalizations. PVT: portal vein thrombosis.

Figure 3. Kaplan-Meier graph for 90-day all-cause readmissions of PVT hospitalizations by sex, showing almost similar distribution by sex in the Kaplan-Meier curve for 90-day readmissions in PVT hospitalizations. PVT: portal vein thrombosis.

**Table 1.** Patient and Hospital Characteristics of PVT Index Hospitalizations and 30-Day Readmissions
Variable	Index hospitalization	30-day readmission	P-value
PVT: portal vein thrombosis; SD: standard deviation.
N	17,971	2,971
Patient characteristics
Female, %	45.5	45.1	0.758
Age, mean ± SD (years)	55.4 ±15.9	57.1±15.2	< 0.001
Age range, %			0.001
18 - 44 years	24.2	19.3
45 - 64 years	46.6	50.1
≥ 65 years	29.2	30.6
Elixhauser comorbidity index score, %			< 0.001
0	7.6	3.1
1	14.2	7.2
2	17.4	11.9
3	15.9	15.3
≥ 4	44.9	62.5
Primary payer, %			< 0.001
Medicare	37.3	42.2
Medicaid	16.8	20.8
Private	41.2	33.4
Uninsured	4.7	3.6
Median annual income in patient’s zip code, US$^#, %			0.715
1 - 45,999	27.4	27.2
46,000 - 58,999	27.9	28.9
59,000 - 78,999	25.4	25.7
≥ 79,000	19.3	18.2
Elixhauser morbidities, %
Congestive heart failure	5.4	9.8	< 0.001
Cardiac arrhythmias	11.2	14.9	< 0.001
Valvular disease	2.0	2.5	0.190
Pulmonary circulation disorders	3.4	3.4	0.993
Peripheral vascular disorders	7.9	6.1	0.009
Hypertension, uncomplicated	37.5	37.0	0.710
Paralysis	0.2	0.4	0.144
Other neurologic disorders	4.9	9.2	< 0.001
Chronic pulmonary disease	14.7	17.5	0.003
Diabetes, uncomplicated	13.9	16.2	0.012
Diabetes, complicated	10.2	15.1	< 0.001
Hypothyroidism	11.8	10.5	0.110
Renal failure	6.9	11.7	< 0.001
Liver disease	41.4	54.1	< 0.001
Peptic ulcer disease	2.2	2.3	0.848
AIDS/HIV	0.4	0.7	0.030
Lymphoma	0.7	0.8	0.863
Metastatic cancer	7.0	13.7	< 0.001
Solid tumor without metastasis	14.3	27.8	< 0.001
RA/collagen vascular disorders	2.7	3.2	0.256
Coagulopathy	26.7	33.9	< 0.001
Obesity	20.1	12.6	< 0.001
Weight loss	11.9	19.3	< 0.001
Fluid and electrolyte disorders	32.7	44.5	< 0.001
Blood loss anemia	1.5	2.2	0.038
Deficiency anemia	7.4	7.2	0.760
Alcohol abuse	14.4	19.8	< 0.001
Drug abuse	4.8	5.4	0.325
Psychoses	0.8	0.9	0.433
Depression	13.4	16.5	0.001
Hypertension, complicated	8.2	12.7	< 0.001
Hospital characteristics
Hospital bed size, %			0.030
Small	14.5	12.5
Medium	25.2	24.1
Large	60.3	63.4
Hospital location/teaching status, %			0.008
Metropolitan non-teaching	17.8	15.9
Metropolitan teaching	77.2	80.4
Non-metropolitan	5.0	3.7

Table 1. Patient and Hospital Characteristics of PVT Index Hospitalizations and 30-Day Readmissions

Variable

Index hospitalization

30-day readmission

P-value

PVT: portal vein thrombosis; SD: standard deviation.

17,971

2,971

Patient characteristics

Female, %

45.5

45.1

0.758

Age, mean ± SD (years)

55.4 ±15.9

57.1±15.2

< 0.001

Age range, %

0.001

18 - 44 years

24.2

19.3

45 - 64 years

46.6

50.1

≥ 65 years

29.2

30.6

Elixhauser comorbidity index score, %

< 0.001

7.6

3.1

14.2

7.2

17.4

11.9

15.9

15.3

≥ 4

44.9

62.5

Primary payer, %

< 0.001

Medicare

37.3

42.2

Medicaid

16.8

20.8

Private

41.2

33.4

Uninsured

4.7

3.6

Median annual income in patient’s zip code, US$^#, %

0.715

1 - 45,999

27.4

27.2

46,000 - 58,999

27.9

28.9

59,000 - 78,999

25.4

25.7

≥ 79,000

19.3

18.2

Elixhauser morbidities, %

Congestive heart failure

5.4

9.8

< 0.001

Cardiac arrhythmias

11.2

14.9

< 0.001

Valvular disease

2.0

2.5

0.190

Pulmonary circulation disorders

3.4

0.993

Peripheral vascular disorders

7.9

6.1

0.009

Hypertension, uncomplicated

37.5

37.0

0.710

Paralysis

0.2

0.4

0.144

Other neurologic disorders

4.9

9.2

< 0.001

Chronic pulmonary disease

14.7

17.5

0.003

Diabetes, uncomplicated

13.9

16.2

0.012

Diabetes, complicated

10.2

15.1

< 0.001

Hypothyroidism

11.8

10.5

0.110

Renal failure

6.9

11.7

< 0.001

Liver disease

41.4

54.1

< 0.001

Peptic ulcer disease

2.2

2.3

0.848

AIDS/HIV

0.4

0.7

0.030

Lymphoma

0.7

0.8

0.863

Metastatic cancer

7.0

13.7

< 0.001

Solid tumor without metastasis

14.3

27.8

< 0.001

RA/collagen vascular disorders

2.7

3.2

0.256

Coagulopathy

26.7

33.9

< 0.001

Obesity

20.1

12.6

< 0.001

Weight loss

11.9

19.3

< 0.001

Fluid and electrolyte disorders

32.7

44.5

< 0.001

Blood loss anemia

1.5

2.2

0.038

Deficiency anemia

7.4

7.2

0.760

Alcohol abuse

14.4

19.8

< 0.001

Drug abuse

4.8

5.4

0.325

Psychoses

0.8

0.9

0.433

Depression

13.4

16.5

0.001

Hypertension, complicated

8.2

12.7

< 0.001

Hospital characteristics

Hospital bed size, %

0.030

Small

14.5

12.5

Medium

25.2

24.1

Large

60.3

63.4

Hospital location/teaching status, %

0.008

Metropolitan non-teaching

17.8

15.9

Metropolitan teaching

77.2

80.4

Non-metropolitan

5.0

3.7

**Table 2.** Patient and Hospital Characteristics of PVT Index Hospitalizations and 90-Day Readmissions
Variable	Index hospitalization	90-day readmission	P-value
PVT: portal vein thrombosis; HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome; SD: standard deviation.
N	14,696	3,737
Patient characteristics
Female, %	45.7	45.1	0.614
Age, mean ± SD (years)	55.5 ± 15.9	57.1 ± 15.3	< 0.001
Age range, %			< 0.001
18 - 44 years	24.2	19.5
45 - 64 years	46.5	48.9
≥ 65 years	29.3	31.6
Elixhauser comorbidity index score, %			<0.001
0	7.7	3.0
1	14.1	6.8
2	17.6	11.6
3	15.8	15.7
≥ 4	44.8	62.9
Primary payer, %			<0.001
Medicare	37.2	43.5
Medicaid	16.5	20.8
Private	41.8	32.5
Uninsured	4.5	3.2
Median annual income in patient’s zip code, US$^#, %			0.492
1 - 45,999	27.2	26.9
46,000 - 58,999	27.9	29.3
59,000 - 78,999	25.3	25.4
≥ 79,000	19.6	18.4
Elixhauser morbidities, %
Congestive heart failure	5.2	8.9	< 0.001
Cardiac arrhythmias	11.2	14.4	< 0.001
Valvular disease	1.9	2.4	0.246
Pulmonary circulation disorders	3.3	3.1	0.623
Peripheral vascular disorders	7.9	6.4	0.018
Hypertension, uncomplicated	37.3	36.9	0.533
Paralysis	0.1	0.5	0.010
Other neurologic disorders	5.0	9.3	< 0.001
Chronic pulmonary disease	14.5	17.8	< 0.001
Diabetes, uncomplicated	14.0	17.5	< 0.001
Diabetes, complicated	10.2	15.2	< 0.001
Hypothyroidism	12.2	11.4	0.343
Renal failure	6.95	11.9	< 0.001
Liver disease	41.4	54.7	< 0.001
Peptic ulcer disease	2.2	2.3	0.877
AIDS/HIV	0.4	0.7	0.021
Lymphoma	0.6	0.7	0.895
Metastatic cancer	6.8	13.3	< 0.001
Solid tumor without metastasis	14.5	28.7	< 0.001
RA/collagen vascular disorders	2.6	2.7	0.817
Coagulopathy	26.3	30.9	< 0.001
Obesity	20.7	12.5	< 0.001
Weight loss	11.7	19.9	< 0.001
Fluid and electrolyte disorders	32.9	43.9	< 0.001
Blood loss anemia	1.5	2.4	0.012
Deficiency anemia	7.5	7.9	0.551
Alcohol abuse	14.4	19.7	< 0.001
Drug abuse	4.9	6.4	0.008
Psychoses	0.8	1.0	0.325
Depression	13.1	15.9	0.002
Hypertension, complicated	8.0	12.6	< 0.001
Hospital characteristics
Hospital bed size, %			0.138
Small	14.6	14.1
Medium	25.6	24.0
Large	59.8	61.9
Hospital location/teaching status, %			0.448
Metropolitan non-teaching	17.6	16.6
Metropolitan teaching	77.4	78.3
Non-metropolitan	5.0	5.1

Table 2. Patient and Hospital Characteristics of PVT Index Hospitalizations and 90-Day Readmissions

Variable

Index hospitalization

90-day readmission

P-value

PVT: portal vein thrombosis; HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome; SD: standard deviation.

14,696

3,737

Patient characteristics

Female, %

45.7

45.1

0.614

Age, mean ± SD (years)

55.5 ± 15.9

57.1 ± 15.3

< 0.001

Age range, %

< 0.001

18 - 44 years

24.2

19.5

45 - 64 years

46.5

48.9

≥ 65 years

29.3

31.6

Elixhauser comorbidity index score, %

<0.001

7.7

3.0

14.1

6.8

17.6

11.6

15.8

15.7

≥ 4

44.8

62.9

Primary payer, %

<0.001

Medicare

37.2

43.5

Medicaid

16.5

20.8

Private

41.8

32.5

Uninsured

4.5

3.2

Median annual income in patient’s zip code, US$^#, %

0.492

1 - 45,999

27.2

26.9

46,000 - 58,999

27.9

29.3

59,000 - 78,999

25.3

25.4

≥ 79,000

19.6

18.4

Elixhauser morbidities, %

Congestive heart failure

5.2

8.9

< 0.001

Cardiac arrhythmias

11.2

14.4

< 0.001

Valvular disease

1.9

2.4

0.246

Pulmonary circulation disorders

3.3

3.1

0.623

Peripheral vascular disorders

7.9

6.4

0.018

Hypertension, uncomplicated

37.3

36.9

0.533

Paralysis

0.1

0.5

0.010

Other neurologic disorders

5.0

9.3

< 0.001

Chronic pulmonary disease

14.5

17.8

< 0.001

Diabetes, uncomplicated

14.0

17.5

< 0.001

Diabetes, complicated

10.2

15.2

< 0.001

Hypothyroidism

12.2

11.4

0.343

Renal failure

6.95

11.9

< 0.001

Liver disease

41.4

54.7

< 0.001

Peptic ulcer disease

2.2

2.3

0.877

AIDS/HIV

0.4

0.7

0.021

Lymphoma

0.6

0.7

0.895

Metastatic cancer

6.8

13.3

< 0.001

Solid tumor without metastasis

14.5

28.7

< 0.001

RA/collagen vascular disorders

2.6

2.7

0.817

Coagulopathy

26.3

30.9

< 0.001

Obesity

20.7

12.5

< 0.001

Weight loss

11.7

19.9

< 0.001

Fluid and electrolyte disorders

32.9

43.9

< 0.001

Blood loss anemia

1.5

2.4

0.012

Deficiency anemia

7.5

7.9

0.551

Alcohol abuse

14.4

19.7

< 0.001

Drug abuse

4.9

6.4

0.008

Psychoses

0.8

1.0

0.325

Depression

13.1

15.9

0.002

Hypertension, complicated

8.0

12.6

< 0.001

Hospital characteristics

Hospital bed size, %

0.138

Small

14.6

14.1

Medium

25.6

24.0

Large

59.8

61.9

Hospital location/teaching status, %

0.448

Metropolitan non-teaching

17.6

16.6

Metropolitan teaching

77.4

78.3

Non-metropolitan

5.0

5.1

**Table 3.** Top 10 Principal Diagnoses of Readmissions for PVT Hospitalizations
Principal readmission diagnoses	Proportion, %
PVT: portal vein thrombosis; HCC: hepatocellular carcinoma.
30-day all-cause readmissions (n = 2,971)
PVT	12.8
Sepsis, unspecified organism	5.5
HCC	4.2
Liver failure	3.6
Alcoholic liver cirrhosis	1.9
Acute liver failure	1.8
Acute kidney failure	1.7
Liver cirrhosis	1.6
Gastrointestinal hemorrhage	1.6
Melena	1.5
90-day all-cause readmissions (n = 3,737)
PVT	9.9
Sepsis, unspecified organism	6.0
HCC	3.9
Liver failure	3.4
Alcoholic liver cirrhosis	2.2
Cirrhosis	1.8
Acute kidney failure	1.8
Gastrointestinal hemorrhage	1.7
Acute liver failure	1.7
Acute pancreatitis	1.5

Table 3. Top 10 Principal Diagnoses of Readmissions for PVT Hospitalizations

Principal readmission diagnoses

Proportion, %

PVT: portal vein thrombosis; HCC: hepatocellular carcinoma.

30-day all-cause readmissions (n = 2,971)

PVT

12.8

Sepsis, unspecified organism

5.5

HCC

4.2

Liver failure

3.6

Alcoholic liver cirrhosis

1.9

Acute liver failure

1.8

Acute kidney failure

1.7

Liver cirrhosis

1.6

Gastrointestinal hemorrhage

1.6

Melena

1.5

90-day all-cause readmissions (n = 3,737)

PVT

9.9

Sepsis, unspecified organism

6.0

HCC

3.9

Liver failure

3.4

Alcoholic liver cirrhosis

2.2

Cirrhosis

1.8

Acute kidney failure

1.8

Gastrointestinal hemorrhage

1.7

Acute liver failure

1.7

Acute pancreatitis

1.5

**Table 4.** Outcomes in PVT 30-Day and 90-Day Readmissions
Outcome	30-day readmission	90-day readmission
PVT: portal vein thrombosis; SE: standard error.
Number	2,971	3,737
In hospital mortality, %	7.7	7.2
Length of hospitalization, mean ± SE (days)	6.49 ± 0.32	6.03 ± 0.26
Total hospital cost, mean US$	18,986	16,549
All-cause readmission rate, %	16.5%	25.4%

Table 4. Outcomes in PVT 30-Day and 90-Day Readmissions

Outcome

30-day readmission

90-day readmission

PVT: portal vein thrombosis; SE: standard error.

Number

2,971

3,737

In hospital mortality, %

7.7

7.2

Length of hospitalization, mean ± SE (days)

6.49 ± 0.32

6.03 ± 0.26

Total hospital cost, mean US$

18,986

16,549

All-cause readmission rate, %

16.5%

25.4%