409 Risk Factors of Readmission to Hospital for Eosinophilic Esophagitis in United States: A National Readmission Database Analysis

Abstract

INTRODUCTION: Eosinophilic esophagitis (EoE), once considered a rare entity, is becoming a commonly encountered gastroenterological condition. In addition to increased clinical recognition of EoE, rising EoE related hospitalization in the United States have been reported. Using the Healthcare Cost and Utilization Project (HCUP) National Readmission Database, we aimed to identify factors associated with readmissions in population with EoE. METHODS: We performed a retrospective cohort study using 2012-2014 data from the Nationwide Readmission Database (NRD). Using International Classification of Diseases-9th Revision, Clinical Modification (ICD-9-CM) codes, we identified patients with discharge diagnoses of EoE (530.13) and ascertained other related comorbidities (asthma (493.XX) and esophageal reflux (530.81)) during index admission. We evaluated patients with EoE related hospitalization, from January 2012 to November 2014, and analyzed readmissions over 90 days after discharge. Logistic regression analyses were used to examine the factors associated with risk of 90-day readmission. RESULTS: Among 6,877 hospitalizations of EoE patients, 407 (3%) were readmitted within 90 days of the index hospitalization resulting in average annual excess charge of roughly $4 million. The common reasons for readmission were foreign body in the esophagus (6%) and dysphagia (7%). Ninety-eight of readmitted EoE cases were ages 19 years or above, and common comorbidities associated with readmissions were GERD (25%) and asthma (26%). In multivariable analysis of patients with EoE, female compared to males (OR 1.94, 95%CI: 1.16–3.24) and having co-morbid asthma compared to no-asthma comorbidity (OR 1.39, 95%CI: 1.25–3.14) were associated with a significant increase in odds of readmission. There was no significant difference in risk of readmission by the type of insurance. CONCLUSION: In a national sample of inpatients with EoE, the risk of 90-day readmission was significantly associated with female and having asthma co-morbidity. These factors may represent targets for interventions to prevent frequent hospital readmission in this population.