Early identification of dehydration with orthostatic blood pressure monitoring in high-output ileostomy patients

Abstract

Background: High readmission rates among ileostomy patients are often the result of dehydration, but this can be prevented with prompt intervention. Aim: This study aimed to determine whether a combination of close follow up and obtaining orthostatic blood pressure would lower 30-day readmission rates in ileostomy patients. Method: Colorectal patients with newly formed ileostomies were enrolled in a surgical transitional care programme. Those with high-output ileostomies were offered education on taking their orthostatic blood pressure at home, and registered nurses completed follow up via telephone. Findings: From December 2017 to April 2019, 171 ileostomy patients were enrolled in a surgical transitional care programme. Of these, 27 patients were provided with orthostatic blood pressure instruction. Readmission rates for the orthostatic blood pressure group were 7.4%, compared with 15.3% in all other ileostomy patients enrolled in surgical transitional care. Conclusion: Orthostatic blood pressure monitoring in high-output ileostomy patients may help to reduce 30-day readmissions.