Examining 30-Day Readmission Rate and Associated Factors in Patients Hospitalized for Diverticulitis Using Nationwide Readmission Database

Abstract

Introduction: Diverticulitis is the third most common cause of hospitalization in the United States. While most have uncomplicated disease course, recurrence and complications can be a major source of morbidity and mortality. However, magnitude of 30-day readmission rate in patients with diverticulitis has not been studied. In addition to studying this, we aim to assess factors associated with 30-day readmissions in patients with diverticulitis. Methods: Nationwide readmission database (NRD), the largest all-payer database containing readmission data was interrogated for the years 2010-2014 to identify records of hospitalized adult patients (>18 years old) with primary hospital diagnosis of diverticulitis (ICD-9-CM 562.11 and 562.13). In patients who survived the index hospitalization, all-cause 30-day readmission (early readmission) rate was calculated. After a univariate analysis examining the differences in patients with and without early readmission, a multivariate survey logistic regression was performed to identify factors associated with early readmission. Results: N=303,346 hospitalizations with diverticulitis were identified, and of these 31.4% were readmitted within 30 days. Table 1 contains the results of univariate analysis comparing patients with and without 30-day readmission after presenting to the hospital for diverticulitis. In the multivariate analysis, age, teaching status of a hospital, payer type, disposition, length of stay, colonic resection, antibiotic use, placement of percutaneous drain, comorbidity index, and peritonitis were all factors associated with 30-day readmission (Table 2). Conclusion: Given that the average 30-day readmission rate for all-cause hospitalizations in the US was approximately 15% during this time, a 31% 30-day readmission rate for patients with diverticulitis is concerning and requires immediate attention. We have identified numerous factors associated with early readmission in these patients, and this can help inform national and local healthcare policy to help prevent early readmissions in these high-risk patient cohort. Specifically, given that surgical interventions (colorectal resection) and use of IV antibiotics use was associated with reduced readmission rate, further prospective research can focus on using these interventions in eligible patients to help reduce significant costs and morbidity associated with early readmissions.141 Figure 1. Examination of 30-day readmission rate in patients presenting with diverticulitis. Percentages displayed above are column percntages.