Hospital readmissions in patients with inflammatory bowel disease

Am J Gastroenterol. 2013 Jul;108(7):1024-32. doi: 10.1038/ajg.2012.343.

Abstract

Objectives: We aimed to identify the frequency and costs of, and the disease predictors and inpatient process issues that may predispose to, 30-day readmission for an inflammatory bowel disease (IBD) patient.

Methods: IBD patients admitted to an inpatient gastroenterology service were followed for a time-to-readmission analysis assessing factors associated with readmission within 30 days.

Results: Index admissions were more costly among those readmitted than among those not readmitted. Patients admitted with evidence of increased inflammation, infection, or obstruction or for dehydration or pain control had a higher risk of readmission. Patients treated with opioid analgesia during index admission were no less likely to be readmitted, and there was a 2.2-fold increase in readmissions when patients were discharged with no opioid analgesia. Scheduling variability and outpatient follow-up compliance were associated with readmission.

Conclusions: Predicting readmission is complex. A predictive model developed to be used at discharge yielded an area under the curve of 0.757.

MeSH terms

  • Abdominal Abscess / diagnostic imaging
  • Abdominal Abscess / etiology
  • Abdominal Abscess / surgery
  • Abdominal Pain / etiology
  • Adult
  • Analgesics, Opioid / therapeutic use
  • Appointments and Schedules
  • Area Under Curve
  • Benzodiazepines / therapeutic use
  • Dehydration / etiology
  • Endoscopy, Gastrointestinal
  • Female
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / economics
  • Inflammatory Bowel Diseases / therapy*
  • Intestinal Obstruction / diagnostic imaging
  • Intestinal Obstruction / etiology
  • Length of Stay
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Care Planning
  • Patient Compliance
  • Patient Readmission / economics
  • Patient Readmission / statistics & numerical data*
  • Proportional Hazards Models
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Analgesics, Opioid
  • Benzodiazepines