OBJECTIVES: Ascites is a common complication in patients with cirrhosis, often requiring large-volume (>5 L) paracentesis (LVP). Albumin is recommended by the American Association for the Study of Liver Diseases to be infused at the time of LVP to mitigate the risks of post-paracentesis circulatory dysfunction. This research examined the time to hospital readmission after discharge among patients who received and did not receive adjunctive albumin during an LVP procedure.

METHODS: A retrospective, observational study was conducted using de-identified patient data (Cerner Real-World Data) to observe outcomes of adult (≥18 years) patients with a diagnosis of cirrhosis and an LVP procedure between January 2016 and September 2019. Hospital visits that lasted >48 hours and patients with hepatorenal syndrome or spontaneous bacterial peritonitis were excluded. Encounters were categorized into ‘LVP’ or ‘LVP + Albumin’. After 1:1 propensity score matching (PSM) on patient demographics, Charlson Comorbidity Index scores, Model for End-Stage Liver Disease (MELD) scores, and hospital care setting, difference in days to hospital readmission within 90 days of discharge for LVP, and non-LVP procedures across both groups were analysed.

RESULTS: A total of 6,225 unique patients with cirrhosis treated with LVP were identified. After PSM, 1,016 patient encounters per group (LVP and LVP + Albumin) were analyzed. Time (in days) to next LVP and non-LVP readmission within 90 days of discharge were examined in each group. The LVP + Albumin group showed a longer hospital-free period to an LVP-related readmission (29.7 ±23.0 vs. 28.8 ±25.0 days) and a non-LVP related readmission (25.7 ±23.6 vs. 24.6 ±22.9 days) compared to the LVP only group.

CONCLUSIONS: Adjunctive albumin infusion in cirrhotic patients during LVP procedures may result in a longer hospital-free time period post-discharge. Future studies examining the effect of adjunctive albumin infusion in LVP procedures on readmission for cirrhotic-related complications are recommended.