S3263 Co-morbidity of Anxiety and Depression in Readmitted Adult Patients With Eosinophilic Esophagitis? A Cross-Sectional Study of the National Readmission Database

Abstract

Introduction: Eosinophilic esophagitis is a chronic medical condition that negatively impacts patients' health-related quality of life (HRQOL). In addition to the inadequate treatment, the disturbing symptoms and patient compliance to a life-long treatment formula could lead to mental health distress in this population. Studies have shown that poor recognition and treatment of psychiatric co-morbidities in chronic medical conditions are associated with increased risks of disease severity, non-adherence to treatment, and increased healthcare costs. This study, therefore, examines the prevalence of co-morbid depression and anxiety in readmitted adult patients with EoE. Methods: Our study population comprised adults ages 19 years or above readmitted within 180 days of index EoE hospitalization. The eligible subjects were identified from the U.S. National Readmission Data between 2012 and 2018, using the ICD9 /10 diagnostic codes recorded during admission. We defined EoE (530.13 or K20.0), depression (311.xx or F32.x), and anxiety (300.xx or F41.x) as having primary or secondary diagnostics codes documented for these conditions during hospitalization. We extracted patient demographic data and hospital factors. We performed descriptive statistics and multivariable analysis to examine the relationship between EoE, depression, and anxiety. Results: A weighted total of 4472 EoE adult patients were readmitted within 180 days of the index EoE hospitalization over seven years. There was no difference in the proportion of readmission by gender. About 81% of the cases readmitted were moderate or high severity, and 74% of the patients reside in small metropolitan/ rural areas. Approximately 18% of the patients readmitted for EoE had co-morbid anxiety symptoms while 11% had co-morbid depressive disorders. Generalized linear models adjusting for demographics and hospital factors showed a significant association between EoE and risk of anxiety (OR, 1.07; 95% CI, 1.02-1.12). There was no evidence of elevated risk of depression in patients readmitted for EoE (OR, 1.03; 95% CI, 0.99-1.07). Medicare or private insurance, and non-teaching hospital admissions, were significantly associated with a lower risk of anxiety in EoE readmissions. Conclusion: Our study supports the evidence of the risk of mental health distress in patients with EoE. We found a significant association between EoE readmission and anxiety. These findings have implications for the assessment and treatment of mental health in patients readmitted for EoE.