Chronic Liver Disease Is Associated with Greater Risk of Hospital Readmission in Patients with Heart Failure: A Nationwide Database Study in the US

OBJECTIVES: Previous studies suggest that chronic liver disease (CLD) is linked to an increased risk of cardiovascular diseases, including HF. This study aimed to determine the association of CLD with 30- and 90-day HF readmission rates in patients with HF.

METHODS: In this retrospective cohort study, we utilized data from the 2019 National Readmission Database (NRD). An index hospitalization was defined as hospitalization for heart failure among patients aged 18 years with an alive discharge status. We would then categorize patients into two groups: patients with and without CLD by capturing the CLD diagnosis in index admission record. We compared 30-day and 90-day all-cause and HF-specific readmission in HF patients with and without CLD. Multiple logistic regression analyses were used to explore the association between CLD and readmissions in HF patients, adjusting for demographic and clinical characteristics. Subgroup analyses were stratified by factors such as age and CLD subtypes, including hepatitis B (HBV), hepatitis C (HCV), nonalcoholic fatty liver disease (NAFLD), and alcoholic cirrhosis (ALC).

RESULTS: The study included 2,370,469 index HF hospitalizations for 30 days and 2,090,370 for 90-day readmission. 17.06% of encounters had all-cause readmission, and 13.71% had HF-specific readmission within 30 days. 31.59% of encounters had all-cause readmission, and 25.89% had HF-specific readmission within 90 days. CLD patients had higher all-cause (Odds ratio (OR) 1.20; 95% CI 1.18-1.23) and HF-specific (1.16;1.14-1.19) readmission rates compared to those without CLD. For 90-day analysis, compared to patients without CLD, patients with CLD also showed higher all-cause (1.19; 1.17-1.21) and HF-specific (1.13; 1.11-1.16) readmission rates.

CONCLUSIONS: Compared to HF patients without CLD, those with CLD were associated with higher 30- and 90-day readmission rates.