title: MELD score and antibiotics use are predictors of length of stay in patients hospitalized with hepatic encephalopathy.
abstract: BACKGROUND
  Hepatic encephalopathy (HE) represents a significant burden to the healthcare system. The aim of this study was to determine factors influencing the hospital length of stay among patients hospitalized with HE.
  
  
  METHODS
  A data warehouse query was performed to identify 316 patients with a first hospitalization during which HE occurred, between April 2010 and February 2012. Baseline and hospitalization characteristics were collected with IRB approval. A negative binomial multivariable model was used to control for potential confounders on the length of hospitalization.
  
  
  RESULTS
  Median age was 59 years, and 60.4% of admitted patients were male. The median MELD score was 22 (IQR: 17-28). Median length of stay was 8 days (IQR: 3.25-14.25). After controlling for MELD score, female gender (2.2 days; p = 0.04), being initially admitted for a reason other than HE (liver-related: 7.6 days; p < 0.01 and non liver-related 10.7 days; p < 0.01) and receiving antibiotics other than rifaximin (10.5 days; p < 0.01) were associated with longer length of stay whereas hepatitis C (-3.1 days; p < 0.01) was associated with a shorter length of stay.
  
  
  CONCLUSIONS
  MELD score, gender, use of antibiotics other than rifaximin, reason for admission and hepatitis C are predictors readily available in clinic that can help identify patients at risk for longer length of stay.
authors.affiliation: Department of Medicine, Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, One Gustave L, Levy Place, New York, NY 10029, USA. valerie.martel-laferriere.chum@ssss.gouv.qc.ca.
authors.forename: Valérie
authors.initials: V
authors.lastname: Martel-Laferrière
authors.forename: Caitlin
authors.initials: C
authors.lastname: Homberger
authors.forename: Kian
authors.initials: K
authors.lastname: Bichoupan
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Dieterich
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D017052:Hospital Mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D012294:Rifamycins / Q000627:therapeutic use; D000078262:Rifaximin; D012737:Sex Factors
chemical_list: D000900:Anti-Bacterial Agents; D012294:Rifamycins; D000078262:Rifaximin