S0805 Predictors of 30-Day Readmission in Ulcerative Colitis: A Nationwide Analysis

Abstract

INTRODUCTION: Ulcerative colitis (UC) is a chronic relapsing and remitting inflammatory bowel diseases (IBD), with frequent hospital admission. Biologics have become the mainstay of therapy in patients with moderate and severe UC. Due to lack of contemporary readmission data since the advent of biologics, we decided to conduct a nationwide readmission study (NRD) on national United States (US) data, to identify the risk factors for 30-day readmission in UC patients after an index admission. METHODS: In this retrospective cohort study, we utilized Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project Nationwide Readmission Database (NRD) for the year 2016 and 2017. In United States, NRD is the largest publicly available all-payer inpatient health care readmission database. We used the ICD10-CM diagnosis code K51.x to identify all adult patients with UC. RESULTS: There were 71,500,000 hospitalizations in 2016-2017 in the United States, 54,138 index admissions had UC as the primary diagnosis whereas 93,192 admission had UC as secondary diagnosis (Figure 1). The 30-day non-elective readmission rate after an index admission with a primary UC diagnosis was 13.2%. We used multivariate logistic regression to identify independent predictors of 30-day readmission. Age< 65, men, longer LOS, higher APR-DRG severity, pulmonary embolism, malnourished, electrolyte imbalance, anemic, anxious, alcohol use and bowel surgery. The variables that were associated with lower odds of 30-day readmission were older age, lower endoscopy, and marijuana use (Table 1). The rest of the variables had no influence on 30-day readmission. CONCLUSION: Our study identified the predictors of 30-day readmission associated with UC in the United States. This calls for a greater recognition of these risk factors and amelioration of its risk-factors, to prevent readmission and decrease mortality, whenever possible.Figure 1.: Flowsheet of the cohort of study population. Unweighted number of patients (weighted number). UC, Ulcerative colitis.Table 1.: Multivariate logistic regression analysis to identify independent risk factors for 30-day readmission in patients with Ulcerative ColitisTable 2.: Multivariate logistic regression analysis to identify independent risk factors for 30-day readmission in patients with Ulcerative Colitis