S2825 Readmission Risk Associated With Falls in Decompensated Cirrhosis: Insights From a National Database

Introduction: Falls represent a significant source of morbidity in patients with decompensated liver cirrhosis, often leading to hospital readmissions and increased healthcare burden. This study aims to evaluate the risk of readmission associated with falls in this patient population, focusing on patient demographics, associated comorbidities, and healthcare utilization trends using the National Readmission Database (NRD) from 2016 to 2021. Methods: A retrospective cohort study was conducted utilizing the NRD from 2016 to 2021. Patients with an initial diagnosis of decompensated liver cirrhosis were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Readmissions with a documented diagnosis of a fall were analyzed. Demographics, comorbidities, length of stay (LOS), and total hospital charges were extracted. Descriptive statistics were calculated to evaluate patient characteristics and associated comorbidities. Trends in admissions and readmissions were analyzed across the study period. Results: A total of 284,225 weighted Index admissions for decompensated liver cirrhosis were identified from 2016 to 2021, including cases with Hepatic Encephalopathy, Bleeding Varices, Ascites, and Spontaneous Bacterial Peritonitis. A total of 5008 weighted readmissions with falls were associated with older age (median: 64 years; IQR: 8 years), longer length of stay (median: 6 days; IQR: 3 days), and higher median total charges ($50,864) compared to the original cohort of decompensated cirrhosis admissions. Patients with recurrent falls frequently presented with complications such as infections, ascites, and worsening liver function. Most patients were discharged home (routine: 1,300), while a significant proportion required transfer to short-term hospitals (1,851) or home health care (1,220). Mortality was documented in 434 cases. Medicare was the most common payer (3,019). followed by Medicaid (1,020) and private insurance (708). Higher readmissions were observed in the lowest-income quartiles (1: 1,513; 2: 1,379). Conclusion: Falls are a major contributor to hospital readmissions in patients with decompensated liver cirrhosis, reflecting a critical need for targeted interventions. Strategies addressing fall prevention, early mobilization, and managing comorbid conditions such as hepatic encephalopathy and coagulopathy may help mitigate this risk. Further research is needed to develop predictive models for falls in this high-risk population and to evaluate the efficacy of multidisciplinary fall prevention programs.