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Mumtaz score for readmission in cirrhosis

Estimates 30-day readmission risk at discharge for decompensated cirrhosis.

Mumtaz score for readmission in cirrhosis
Age
Primary insurance payer
Elixhauser comorbidity index >=3
Non-alcoholic etiology of cirrhosis
Ascites
Hepatic encephalopathy
Variceal bleeding
Hepatocellular carcinoma
Paracentesis during index admission
Hemodialysis during index admission
Discharge disposition
Result0 points

Medium approximate risk band. The original validation cohort stratified patients into low (<20%), medium (20-30%), and high (>30%) predicted probability of 30-day readmission; exact probability requires the published logistic model.

Risk band
Medium approximate risk band

When to use

  • At discharge in adults with decompensated cirrhosis, to flag patients who may benefit from intensified post-discharge follow-up.
  • Not intended for patients on mechanical ventilation, under palliative care, post-liver transplant, or admitted electively.

Formula

Sum of points: age 18-39 (+7), 40-64 (+4), >=65 (0); primary payer Medicare (+4), Medicaid (+5), private (0), self-pay (-3), no charge/other (-1); Elixhauser index >=3 (+2); non-alcoholic etiology (+2); ascites (+5); hepatic encephalopathy (+4); variceal bleeding (-7); hepatocellular carcinoma (+3); paracentesis (+4); hemodialysis (+7); disposition routine (0), transfer (-1), home health (+1), against medical advice (+10). Score range -11 to +49.

Pearls and pitfalls

  • Derived and internally validated from the 2013-2014 US Nationwide Readmission Database (>120,000 index admissions for decompensated cirrhosis).
  • About 1 in 3 patients with decompensated cirrhosis are readmitted within 30 days, most for a liver-related diagnosis.

References

  1. Mumtaz K, Issak A, Porter K, et al. Validation of Risk Score in Predicting Early Readmissions in Decompensated Cirrhotic Patients: A Model Based on the Administrative Database. Hepatology. 2019;70(2):630-639.