Observational Study
Copyright ©The Author(s) 2017.
World J Gastroenterol. Mar 14, 2017; 23(10): 1857-1865
Published online Mar 14, 2017. doi: 10.3748/wjg.v23.i10.1857
Table 1 Patient and hospital characteristics by hospital performance quintile in risk and reliability-adjusted cirrhosis mortality
Q1 (highest performance)Q2Q3Q4Q5 (lowest performance)OverallP value
Patient characteristics
Patients215241111712427126481501772733-
Demographics
Age
Mean age (yr)56.857.557.657.357.457.2< 0.00001
Sex
Female (%)36.436.735.935.035.335.90.01381
Race
White (%)59.955.654.851.752.655.4< 0.00001
Black (%)5.87.75.65.79.06.7
Hispanic (%)15.220.221.517.420.318.5
Asian or Pacific Islander (%)1.61.82.31.32.21.8
Native American (%)1.60.50.81.10.91.1
Other (%)1.62.02.63.33.12.4
Missing (%)14.412.112.419.612.014.1
Insurance
Medicare (%)36.137.238.036.937.337.0< 0.00001
Medicaid (%)22.924.524.823.826.524.4
Private Insurance (%)27.426.525.225.322.525.5
Self-Pay (%)7.57.47.38.47.87.7
No Charge (%)1.00.40.60.51.50.9
Other (%)5.04.04.05.04.34.6
Cause of cirrhosis1
Alcoholic liver disease (%)61.062.561.060.860.361.10.00880
Alcoholic cirrhosis (%)60.962.460.960.660.260.90.00589
Non-alcoholic cirrhosis (%)38.036.938.038.639.038.10.00762
Biliary cirrhosis (%)2.31.52.01.71.61.9< 0.00001
HCV positive (%)25.323.022.125.126.424.6< 0.00001
Unspecified liver disease or cirrhosis (%)2.72.02.02.01.82.2< 0.00001
A1AT, Cu, Fe disease (%)0.890.650.640.740.680.740.04067
Complications of Cirrhosis
Ascites (%)31.827.530.230.326.929.6< 0.00001
Variceal bleed (%)9.610.39.69.39.49.60.05605
Hepatic Encephalopathy (%)53.755.252.554.155.754.2< 0.00001
Portal HTN (%)44.341.144.942.741.543.0< 0.00001
Hepatorenal syndrome (%)9.37.88.28.38.98.60.00003
Hepatocellular carcinoma (%)3.92.73.13.13.23.3< 0.00001
Procedures
Liver transplant2.70.61.01.12.41.7< 0.00001
Esophagogastroduodenoscopy18.119.020.419.318.318.9< 0.00001
Paracentesis32.929.730.029.729.230.6< 0.00001
Mortality characteristics
APR-DRG Risk of Mortality
Minor risk of mortality (%)5.97.86.86.59.17.1< 0.00001
Moderate risk of mortality (%)31.334.134.433.234.033.2
Major risk of mortality (%)41.039.439.439.537.039.4
Extreme risk of mortality (%)21.818.719.420.719.920.3
Mortality
Expired during admission (%)5.16.07.59.812.37.9< 0.00001
Hospital characteristic
Number of hospitals161161161161161805-
Region
Northeast hospital region (%)19.325.527.324.834.226.20.06961
Midwest hospital region (%)18.613.717.413.09.314.4
South hospital region (%)29.232.319.929.226.727.5
West hospital region (%)32.928.635.432.929.831.9
Bed capacity
Small bedsize (%)23.041.036.633.532.333.30.05554
Medium bedsize (%)37.931.732.934.229.833.3
Large bedsize (%)39.127.330.432.337.933.4
Hospital ICU beds (mean)24.319.120.119.920.820.80.04608
Patient casemix
Hospital Cirrhosis Annual Volume (mean)133.769.077.278.693.390.4< 0.00001
Medicaid Days (mean)1813915339181581869922662185990.18260
Admission characteristics
Length of stay (days) (mean)5.95.75.96.26.46.00.00019
Total charges ($ mean)24339136593405004338940340408770.19458
Expired during admission (%)4.05.37.310.113.28.0< 0.00001
Staffing characteristics
Full-time LPN’s3 (mean)1.652.182.181.942.342.060.03218
Full-time MD’s3 (mean)2.742.022.551.881.82.20.27122
Teaching Status
Teaching hospital4 (%)42.932.938.539.841.639.10.40386
Resident FTE’s (mean)79.240.757.759.065.760.50.33158
Specialty Services
Liver transplant hospital (%)15.55.05.05.64.37.10.00020