S0742 Trend and Predictors of Readmission With Venous Thromboembolism Following Hospitalization in Patients With Inflammatory Bowel Disease

Abstract

INTRODUCTION: Patients with Inflammatory bowel disease (IBD) are at increased risk of venous thromboembolism (VTE). VTE prophylaxis, mainly with pharmacological measures, may not be instituted due fear of worsening bleeding or anemia- both of which many patients are at risk of at the time of presentation. Therefore, we assessed yearly 30-day readmission primarily with VTE in patients with IBD. We also assessed factors contributing to VTE readmission independently. METHODS: Data was obtained from the Nationwide Readmissions Database to identify all IBD-related admissions from 2010 through 2014 using ICD-9-CM codes. Complications and procedures during hospitalization were also identified with the same methodology. We excluded patients from the readmission analysis with the following: age <18, death during initial hospitalization, elective readmissions, discharged in December of each year. All readmitted patients were queried to determine if readmission was secondary to VTE. Yearly trend was assessed with Cochrane Armitage Trend test. Multivariable regression was used to assess risk factors associated with VTE readmission with adjusted OR (aOR). RESULTS: Total of 1,350,428 hospitalized patients with IBD were followed for 30 days and included in the analysis. Out of 234,261 patients, 13,667 (5.8%) patients had readmission with VTE. Baseline characteristics of index hospitalization are shown in Table 1. Proportions of readmissions related to VTE increased from 5.5% to 6.2% over the study period as shown in Figure 1. Younger age group (18-39) had 25% lower readmission with VTE compared to older patients (≥65 years). Morbid obesity did not affect readmission rates with VTE. Patients requiring total parenteral nutrition (TPN) nearly had a 2-fold increase in odds of readmission with VTE. After adjusting for confounding, odds of readmission with VTE doubled for patients with an initial hospital length of more than 3 days. Patients with anemia on hospitalization had a 30% higher odds of readmission with VTE independently. Other factors associated with increased odds of readmission with VTE are shown in Table 2. CONCLUSION: Younger age group (<65) and females have lower readmission with VTE. Length of stay more than 3 days and requiring TPN on initial hospitalization doubled odds of readmission with VTE in IBD patients. Anemic patients had higher readmission rates with VTE. Decreasing unnecessary stay and ensuring VTE prophylaxis in anemic patients may decrease VTE related readmissions in IBD patients.Table 1.: Baseline characteristics of patient population during index hospitalizationTable 2.: Factors associated with readmission for VTE in patients with IBDFigure 1.: Readmission rate trend for VTE in patients with IBD.