Cargando…

Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease

BACKGROUND: Management of inpatients with inflammatory bowel disease (IBD) requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD. MATERIALS & METHODS: We collected data from the Healthcare Cost and Utilization Project Nationw...

Descripción completa

Detalles Bibliográficos
Autores principales: Micic, Dejan, Gaetano, John N., Rubin, Jonah N., Cohen, Russell D., Sakuraba, Atsushi, Rubin, David T., Pekow, Joel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570509/
https://www.ncbi.nlm.nih.gov/pubmed/28837634
http://dx.doi.org/10.1371/journal.pone.0182900
_version_ 1783259191717134336
author Micic, Dejan
Gaetano, John N.
Rubin, Jonah N.
Cohen, Russell D.
Sakuraba, Atsushi
Rubin, David T.
Pekow, Joel
author_facet Micic, Dejan
Gaetano, John N.
Rubin, Jonah N.
Cohen, Russell D.
Sakuraba, Atsushi
Rubin, David T.
Pekow, Joel
author_sort Micic, Dejan
collection PubMed
description BACKGROUND: Management of inpatients with inflammatory bowel disease (IBD) requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD. MATERIALS & METHODS: We 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. RESULTS: We 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). CONCLUSION: Analyzing 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.
format Online
Article
Text
id pubmed-5570509
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-55705092017-09-09 Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease Micic, Dejan Gaetano, John N. Rubin, Jonah N. Cohen, Russell D. Sakuraba, Atsushi Rubin, David T. Pekow, Joel PLoS One Research Article BACKGROUND: Management of inpatients with inflammatory bowel disease (IBD) requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD. MATERIALS & METHODS: We 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. RESULTS: We 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). CONCLUSION: Analyzing 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. Public Library of Science 2017-08-24 /pmc/articles/PMC5570509/ /pubmed/28837634 http://dx.doi.org/10.1371/journal.pone.0182900 Text en © 2017 Micic et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Micic, Dejan
Gaetano, John N.
Rubin, Jonah N.
Cohen, Russell D.
Sakuraba, Atsushi
Rubin, David T.
Pekow, Joel
Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
title Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
title_full Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
title_fullStr Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
title_full_unstemmed Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
title_short Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
title_sort factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570509/
https://www.ncbi.nlm.nih.gov/pubmed/28837634
http://dx.doi.org/10.1371/journal.pone.0182900
work_keys_str_mv AT micicdejan factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease
AT gaetanojohnn factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease
AT rubinjonahn factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease
AT cohenrusselld factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease
AT sakurabaatsushi factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease
AT rubindavidt factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease
AT pekowjoel factorsassociatedwithreadmissiontothehospitalwithin30daysinpatientswithinflammatoryboweldisease