Table 2.
Multivariate Analysis of Factors Associated with Palliative Care Consultation Among Patients Hospitalized for End-Stage Liver Disease, Nationwide Readmissions Database 2010–2014
| Characteristics | Adjusted odds ratio | Lower confidence limit | Upper confidence limit | p |
|---|---|---|---|---|
| Age | ||||
| Per 10-year increase | 1.08 | 1.02 | 1.15 | 0.0091 |
| Sex | ||||
| Female vs. male | 1.03 | 0.93 | 1.14 | 0.5588 |
| DNR | 10.01 | 8.67 | 11.55 | <0.0001 |
| Hepatocellular carcinoma | 3.00 | 2.41 | 3.73 | <0.0001 |
| Liver transplant | 0.08 | 0.04 | 0.16 | <0.0001 |
| Complications of ESLD | ||||
| Ascites | 1.41 | 1.18 | 1.69 | 0.0002 |
| Variceal hemorrhage or bleeding | 0.89 | 0.79 | 0.99 | 0.0364 |
| Hepatorenal syndrome | 2.41 | 2.15 | 2.70 | <0.0001 |
| Hepatic encephalopathy | 1.49 | 1.31 | 1.69 | <0.0001 |
| Portal hypertension | 0.89 | 0.81 | 0.99 | 0.0251 |
| Jaundice | 1.30 | 1.10 | 1.54 | 0.0027 |
| Spontaneous bacterial peritonitis | 1.29 | 1.13 | 1.47 | 0.0002 |
| Protein–energy malnutrition | 2.04 | 1.63 | 2.55 | <0.0001 |
| Insurance | ||||
| Medicare | Reference | 0.0003 | ||
| Medicaid | 1.09 | 0.95 | 1.25 | |
| Private | 0.96 | 0.83 | 1.11 | |
| Self-pay and others | 1.40 | 1.17 | 1.66 | |
| Median household income | ||||
| First quartile | Reference | 0.0262 | ||
| Second quartile | 0.84 | 0.74 | 0.96 | |
| Third quartile | 0.95 | 0.82 | 1.09 | |
| Fourth quartile | 0.86 | 0.74 | 0.99 | |
| Hospital bed size | ||||
| Small | 0.4401 | |||
| Medium | 1.23 | 0.88 | 1.72 | |
| Large | 1.14 | 0.84 | 1.55 | |
| Hospital location (%) | ||||
| Large metropolitan | Reference | 0.024 | ||
| Small metropolitan | 1.18 | 1.03 | 1.34 | |
| Micropolitan | 0.59 | 0.43 | 0.82 | |
| Nonmicro/metropolitan | 0.36 | 0.16 | 0.79 | |
| Hospital teaching status | ||||
| Nonteaching vs. teaching | 0.81 | 0.70 | 0.93 | 0.0028 |
| Hospital ownership | ||||
| Government | Reference | 0.0683 | ||
| Private, nonprofit | 1.03 | 0.88 | 1.20 | |
| Private, profit | 0.73 | 0.54 | 0.99 | |
| Weekend admission | 1.03 | 0.92 | 1.14 | 0.6184 |
| Discharge disposition | ||||
| Skilled nursing facilities | Reference | <0.0001 | ||
| Home (and home with hospice) | 0.40 | 0.35 | 0.44 | |
| Leaving against medical advice | 0.15 | 0.09 | 0.25 | |
| Comorbidities | ||||
| Alcohol abuse | 1.22 | 1.10 | 1.35 | 0.0001 |
| Coagulation disorders | 1.14 | 1.03 | 1.26 | 0.011 |
| Complicated diabetes mellitus | 0.69 | 0.54 | 0.88 | 0.0026 |
| Drug abuse | 1.19 | 1.02 | 1.39 | 0.0286 |
| Metastatic cancer | 1.56 | 1.10 | 2.20 | 0.0119 |
| Charlson–Deyo comorbidity index | ||||
| 0 | Reference | <0.0001 | ||
| 1–3 | 1.10 | 0.97 | 1.25 | |
| >3 | 1.86 | 1.51 | 2.29 | |
Self-pay and others, individuals without a health insurance or paying health fees out of pocket. Large metropolitan (population ≥1,000,000), small metropolitan (population between 50,000 and 1,000,000), micropolitan (population between 10,000 and 50,000), and non micro-/metropolitan (population <10,000).