Aims
This study utilizes data from the Nationwide Admission Database (HCUP) from 2019 to 2024, analyzing 2,858,576 adult hospital admissions to assess the link between obesity and readmission rates in cirrhotic patients with variceal bleeding. It examines the impact of obesity, race, and gender on 30-day and 60-day readmission rates, employing chi-square tests and logistic regression to evaluate disparities across demographics. The models, which include race and gender, were analyzed for predictive accuracy using ROC curves and AUC statistics to enhance patient management strategies.
Methods
This study analyzed data from the Nationwide Admission Database (HCUP) involving 2,858,576 adults from 2019 to 2024, focusing on 30-day and 60-day readmission rates for obese cirrhotic patients with variceal bleeding. It assessed the impact of obesity, race, and gender on these outcomes using chi-square tests and logistic regression to explore incidence and readmission disparities across demographics. The effectiveness of these models, incorporating race and gender, was evaluated through ROC curves and AUC statistics to pinpoint key predictors of readmission.
Results
From 2019 to 2024, the Nationwide Admission Database (HCUP) provided data on 2,858,576 adult admissions, focusing on 110,124 patients diagnosed with cirrhosis and variceal bleeding, including 47,510 obese individuals (BMI over 30). Chi-square tests indicated significantly higher readmission rates for obese patients, with a p-value of 0.014 for 30-day and < 0.001 for 60-day readmissions. The incidence of variceal bleeding also varied by obesity status, showing a p-value of 0.020. Logistic regression highlighted gender and race impacts on readmissions, particularly males and Hispanics influencing 60-day outcomes with coefficients of 0.62 and 0.54, respectively. The AUC for the 30-day model showed excellent predictive accuracy.
Conclusions
This analysis shows obese patients have higher readmission rates than non-obese peers, highlighting complex care challenges. Logistic regression found gender and race—especially male and Hispanic patients—significantly affect 60-day readmissions. The 30-day model’s high AUC confirms its predictive value, emphasizing the need for targeted interventions and healthcare strategies tailored to at-risk groups in managing cirrhosis.