Fatty Liver Disease May Increase Risk of Hospital Readmission in Cardiac Patients

James Frederick, PA-C, MMSc avatar

by James Frederick, PA-C, MMSc |

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NAFLD's link to cardiac hospital readmission

A recent study has suggested that nonalcoholic fatty liver disease (NAFLD) may contribute to increased rates of hospital readmission in patients suffering from heart failure.

The study, “Nonalcoholic fatty liver disease and increased risk of 1-year all-cause and cardiac hospital readmissions in elderly patients admitted for acute heart failure,” was published in the journal PLOS One.

Heart failure causes considerable morbidity and mortality worldwide, particularly among the elderly. With a global prevalence of more than 10 percent among patients who are age 70 or older, heart failure has also been implicated as a major cause of hospital readmission.

High readmission rates suggest that the current cardiac treatment among the elderly may not be effective, according to the authors. They suggest that identifying patients who are at increased risk of hospital readmission may help improve discharge planning, which in turn may lead to decreased rates of hospital readmission.

Increasing evidence has suggested that nonalcoholic fatty liver disease may be linked to heart failure. The authors note that NAFLD may affect cardiac metabolism, contributing to the development of arrhythmias and cardiac remodeling that have been implicated in the onset of heart failure.

To determine if NAFLD was independently associated with increased rates of hospital readmission in cardiac patients, the authors followed 212 heart failure patients admitted to the Hospital of Negrar in Verona, Italy.

The patients were screened for NALFD via ultrasonography. The severity of NAFLD was determined through a noninvasive fibrosis scoring system (FIB-4). Patients were then followed for a year and hospital readmission rates were recorded. Patients with pre-existing conditions such as heart attack, end-stage renal disease, cancer, and cirrhosis were excluded from the study.

After adjusting for potential confounding variables, researchers found that patients with NAFLD were five times more likely to require hospital readmission. Interestingly, heart failure patients diagnosed with NAFLD had similarly increased rates of readmission for both cardiac and noncardiac-related reasons.

“In conclusion, our results show that NAFLD and its severity — using the FIB-4 score or other noninvasive markers of advanced NAFLD fibrosis — were strongly and independently associated with an increased risk of 1-year all-cause and cardiac re-hospitalization in elderly patients admitted for acute HF,” the researchers wrote.

They noted that additional prospective studies are needed to corroborate their findings in other independent samples.