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Introduction: Liver cirrhosis (LC) is a major cause of mortality andmorbidity in the United States. American Association for the Study of LiverDisease (AASLD) has developed guidelines for the management of patients withLC. Methods: We conducted a one-year retrospective chart review study ofpatients admitted with LC related complication. Our primary outcome wasadherence to AASLD guidelines for the management of variceal bleeding (VB),fluid overload and hepatocellular carcinoma (HCC) screening, and secondaryoutcome was re-admission rate within 30 days of discharge. Results: A total of139 patients were reviewed. Majority were males (65%) and Caucasians (65%). Theadmission indication was mainly for fluid overload (39%), hepaticencephalopathy (36%) and VB (27%). The one-month readmission rate was 31%, ofthose 47% and 37% were admitted for hepatic encephalopathy and fluid overloadrespectively. Periodic screening for HCC was done in only 40% of patients.Ninety-five percent of patients admitted with VB received PPI, octreotride andantibiotics. Diet education was only documented in 9% of patients on discharge.Significant predictors for 30-day readmission included high MELD score,elevated creatinine, and taking diuretics/lactulose before hospitalization inaddition to shorter length of stay. Conclusion: Compliance with AASLDguidelines was optimal for patients with VB. Further optimization is requiredfor HCC screening and patient education. Multiple factors play a role inreadmissions for patients with cirrhosis; this model helps to identify patientsat risk for readmission and opens an area for quality improvement measures toavoid unnecessary hospitalizations.

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Adherence to American Association for the Study of Liver Diseases (AASLD) Guidelines and Predictors of Readmission in Cirrhotic Patients: A Single Center Experience