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Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter?
BACKGROUND: Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. METHODS: A retrospective cohort study w...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803990/ https://www.ncbi.nlm.nih.gov/pubmed/29502532 http://dx.doi.org/10.1186/s40779-018-0153-x |
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author | Malhotra, Ashish Phatharacharukul, Parkpoom Thongprayoon, Charat |
author_facet | Malhotra, Ashish Phatharacharukul, Parkpoom Thongprayoon, Charat |
author_sort | Malhotra, Ashish |
collection | PubMed |
description | BACKGROUND: Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. METHODS: A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem. All-cause readmissions within 30 and 90 days were recorded to calculate early readmission rates. The multivariate logistic regression was used to identify the potential risk factors for 90-day readmission. RESULTS: There were 130 unique patients (56.9% with Crohn’s disease and 43.1% with ulcerative colitis) with 202 IBD-related index admissions. The mean age at the time of index admission was 59.8 ± 15.2 years. The median time to re-hospitalization was 26 days (IQR 10-49), with 30- and 90-day readmission rates of 17.3% (35/202) and 29.2% (59/202), respectively. Reasons for all-cause readmission were IBD-related (71.2%), scheduled surgery (3.4%) and non-gastrointestinal causes (25.4%). The following reasons were independently associated with 90-day readmission: Crohn’s disease (OR 3.90; 95% CI 1.82-8.90), use of antidepressants (OR 2.19; 95% CI 1.12-4.32), and lack of follow-up within 90 days with a primary care physician (PCP) (OR 2.63; 95% CI 1.32-5.26) or a gastroenterologist (GI) (OR 2.44; 95% CI 1.20-5.00). 51.0% and 49.0% of patients had documentation of a recommended outpatient follow-up with PCP and/or GI, respectively. CONCLUSIONS: Early readmission in IBD is common. Independent risk factors for 90-day readmission included Crohn’s disease, use of antidepressants and lack of follow-up visit with PCP or GI. Further research is required to determine if the appropriate timing of post-discharge follow-up can reduce IBD readmissions. |
format | Online Article Text |
id | pubmed-5803990 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58039902018-02-14 Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? Malhotra, Ashish Phatharacharukul, Parkpoom Thongprayoon, Charat Mil Med Res Research BACKGROUND: Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. METHODS: A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem. All-cause readmissions within 30 and 90 days were recorded to calculate early readmission rates. The multivariate logistic regression was used to identify the potential risk factors for 90-day readmission. RESULTS: There were 130 unique patients (56.9% with Crohn’s disease and 43.1% with ulcerative colitis) with 202 IBD-related index admissions. The mean age at the time of index admission was 59.8 ± 15.2 years. The median time to re-hospitalization was 26 days (IQR 10-49), with 30- and 90-day readmission rates of 17.3% (35/202) and 29.2% (59/202), respectively. Reasons for all-cause readmission were IBD-related (71.2%), scheduled surgery (3.4%) and non-gastrointestinal causes (25.4%). The following reasons were independently associated with 90-day readmission: Crohn’s disease (OR 3.90; 95% CI 1.82-8.90), use of antidepressants (OR 2.19; 95% CI 1.12-4.32), and lack of follow-up within 90 days with a primary care physician (PCP) (OR 2.63; 95% CI 1.32-5.26) or a gastroenterologist (GI) (OR 2.44; 95% CI 1.20-5.00). 51.0% and 49.0% of patients had documentation of a recommended outpatient follow-up with PCP and/or GI, respectively. CONCLUSIONS: Early readmission in IBD is common. Independent risk factors for 90-day readmission included Crohn’s disease, use of antidepressants and lack of follow-up visit with PCP or GI. Further research is required to determine if the appropriate timing of post-discharge follow-up can reduce IBD readmissions. BioMed Central 2018-02-08 /pmc/articles/PMC5803990/ /pubmed/29502532 http://dx.doi.org/10.1186/s40779-018-0153-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Malhotra, Ashish Phatharacharukul, Parkpoom Thongprayoon, Charat Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? |
title | Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? |
title_full | Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? |
title_fullStr | Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? |
title_full_unstemmed | Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? |
title_short | Risk factors for 90-day readmission in veterans with inflammatory bowel disease—Does post-discharge follow-up matter? |
title_sort | risk factors for 90-day readmission in veterans with inflammatory bowel disease—does post-discharge follow-up matter? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803990/ https://www.ncbi.nlm.nih.gov/pubmed/29502532 http://dx.doi.org/10.1186/s40779-018-0153-x |
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