Abstract
BackgroundManagement of inpatients with inflammatory bowel disease (IBD) requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD.Materials & methodsWe collected data from the Healthcare Cost and Utilization Project Nationwide Readmissions Database 2013. We identified individuals with index hospitalizations for IBD. Patient-specific factors, comorbidities and hospitalization characteristics were extracted for the index hospitalization. We performed logistic regression modeling to create adjusted odds ratios (ORs) for 30-day hospital readmission. Subgroup analysis was performed based on disease type and performance of surgery.ResultsWe analyzed a total of 55,942 index hospital discharges; 3037 patients (7.0%) were readmitted to the hospital within 30 days. Increasing patient age (> 65: OR: 0.45; 95% CI 0.39–0.53) was associated with a decreased risk of readmission, while a diagnosis of Crohn’s disease (OR: 1.09; 95% CI 1.00–1.18) and male sex (OR: 1.16; 95% CI 1.07–1.25) were associated with an increased risk of readmission. The comorbidities of smoking (OR: 1.09; 95% CI 1.00–1.19), anxiety (OR: 1.17; 95% CI 1.01–1.36) and opioid dependence (OR: 1.40; 95% CI 1.06–1.86) were associated with an increased risk of 30-day readmission. Individual hospitalization characteristics and disease complications were significantly associated with readmission. Performance of a surgery during the index admission was associated with a decreased risk of readmission (OR: 0.57; 95% CI 0.33–0.96).ConclusionAnalyzing data from a US publicly available all-payer inpatient healthcare database, we identified patient and hospitalization risk factors associated with 30-day readmission. Identifying patients at high risk for readmission may allow for interventions during or after the index hospitalization to decrease this risk.
Highlights
Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect approximately 1.6 million people in the United States [1]
We aimed to identify factors associated with hospital readmissions among individuals with IBD
The comorbidities of smoking (OR: 1.09; 95% confidence intervals (CI) 1.00–1.19), anxiety (OR: 1.17; 95% CI 1.01–1.36) and opioid dependence (OR: 1.40; 95% CI 1.06–1.86) were associated with an increased risk of 30-day readmission
Summary
Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect approximately 1.6 million people in the United States [1]. The incidence and prevalence of inflammatory bowel disease is rising worldwide with increased trends in the rates of hospitalization and resource utilization [1]. A meta-analysis of population based studies demonstrated pooled risks of surgery at 1 year and 5 years for CD to be 14.3% and 27.7% and for UC 4.1% and 9.9%, respectively, with a decreased trend in surgical rates over the past 6 decades [2]. This decrease in surgical rates is hypothesized to be related to increased exposure to and use of biologic therapies as CD-related hospitalizations and intra-abdominal surgeries were decreased with infliximab maintenance therapy in the pivotal ACCENT I and II studies [3, 4]. We aimed to identify factors associated with hospital readmissions among individuals with IBD
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