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Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis

BACKGROUND/AIMS: Gastroparesis is a chronic gastrointestinal disorder that frequently presents with symptoms that are difficult to manage, necessitating frequent hospitalizations. We sought to determine the predictors of early readmission due to gastroparesis based on etiology. METHODS: We identifie...

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Autores principales: Pavurala, Ravi B, Stanich, Peter P, Krishna, Somashekar G, Guturu, Praveen, Hinton, Alice, Conwell, Darwin L, Balasubramanian, Gokulakrishnan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Neurogastroenterology and Motility 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266506/
https://www.ncbi.nlm.nih.gov/pubmed/34210906
http://dx.doi.org/10.5056/jnm20105
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author Pavurala, Ravi B
Stanich, Peter P
Krishna, Somashekar G
Guturu, Praveen
Hinton, Alice
Conwell, Darwin L
Balasubramanian, Gokulakrishnan
author_facet Pavurala, Ravi B
Stanich, Peter P
Krishna, Somashekar G
Guturu, Praveen
Hinton, Alice
Conwell, Darwin L
Balasubramanian, Gokulakrishnan
author_sort Pavurala, Ravi B
collection PubMed
description BACKGROUND/AIMS: Gastroparesis is a chronic gastrointestinal disorder that frequently presents with symptoms that are difficult to manage, necessitating frequent hospitalizations. We sought to determine the predictors of early readmission due to gastroparesis based on etiology. METHODS: We identified all adults discharged with a principal diagnosis of gastroparesis after hospitalization from the 2014 Nationwide Readmission Database. We compared etiology wise (diabetes, post-surgical, and idiopathic) early readmission. Multivariate regression analyses were performed to identify significant predictors of 30-day readmission. RESULTS: A total of 12 689 patients were identified, 30.7% diabetic, 2.6% post-surgical, and 66.7% were idiopathic. Patients with diabetic gastroparesis were more likely to be readmitted within 30 days than idiopathic (adjusted odds ratio [aOR], 0.81; 95% confidence interval [CI], 0.69-0.94) and post-surgical gastroparesis (aOR, 0.58; 95% CI, 0.34-0.98). Pyloroplasty was associated with less likelihood of 30-day readmission (aOR, 0.45; 95% CI, 0.20-0.97). In addition, male gender (aOR, 1.18; 95% CI, 1.02-1.37), modified Elixhauser comorbidity score ≥ 3 (aOR, 1.38; 95% CI, 1.18-1.61), chronic pain syndrome (aOR, 1.41; 95% CI, 1.11-1.78), younger (18-64 years) age (aOR, 1.64; 95% CI, 1.34-2.00), need for percutaneous endoscopic gastrostomy/jejunostomy tube (aOR, 2.06; 95% CI, 1.21-3.52), and need for total parenteral nutrition (aOR, 1.70; 95% CI, 1.24-2.35) were associated with increased risk of 30-day readmission. CONCLUSIONS: One in 5 patients was readmitted with gastroparesis within 30 days. In the diabetic group, diabetes-related complications contributed to readmissions than gastroparesis. Pyloroplasty is associated with reduced early hospital readmission. Prospective studies are needed for validation of these results.
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spelling pubmed-82665062021-07-30 Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis Pavurala, Ravi B Stanich, Peter P Krishna, Somashekar G Guturu, Praveen Hinton, Alice Conwell, Darwin L Balasubramanian, Gokulakrishnan J Neurogastroenterol Motil Original Article BACKGROUND/AIMS: Gastroparesis is a chronic gastrointestinal disorder that frequently presents with symptoms that are difficult to manage, necessitating frequent hospitalizations. We sought to determine the predictors of early readmission due to gastroparesis based on etiology. METHODS: We identified all adults discharged with a principal diagnosis of gastroparesis after hospitalization from the 2014 Nationwide Readmission Database. We compared etiology wise (diabetes, post-surgical, and idiopathic) early readmission. Multivariate regression analyses were performed to identify significant predictors of 30-day readmission. RESULTS: A total of 12 689 patients were identified, 30.7% diabetic, 2.6% post-surgical, and 66.7% were idiopathic. Patients with diabetic gastroparesis were more likely to be readmitted within 30 days than idiopathic (adjusted odds ratio [aOR], 0.81; 95% confidence interval [CI], 0.69-0.94) and post-surgical gastroparesis (aOR, 0.58; 95% CI, 0.34-0.98). Pyloroplasty was associated with less likelihood of 30-day readmission (aOR, 0.45; 95% CI, 0.20-0.97). In addition, male gender (aOR, 1.18; 95% CI, 1.02-1.37), modified Elixhauser comorbidity score ≥ 3 (aOR, 1.38; 95% CI, 1.18-1.61), chronic pain syndrome (aOR, 1.41; 95% CI, 1.11-1.78), younger (18-64 years) age (aOR, 1.64; 95% CI, 1.34-2.00), need for percutaneous endoscopic gastrostomy/jejunostomy tube (aOR, 2.06; 95% CI, 1.21-3.52), and need for total parenteral nutrition (aOR, 1.70; 95% CI, 1.24-2.35) were associated with increased risk of 30-day readmission. CONCLUSIONS: One in 5 patients was readmitted with gastroparesis within 30 days. In the diabetic group, diabetes-related complications contributed to readmissions than gastroparesis. Pyloroplasty is associated with reduced early hospital readmission. Prospective studies are needed for validation of these results. The Korean Society of Neurogastroenterology and Motility 2021-07-30 2021-07-30 /pmc/articles/PMC8266506/ /pubmed/34210906 http://dx.doi.org/10.5056/jnm20105 Text en © 2021 The Korean Society of Neurogastroenterology and Motility https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Pavurala, Ravi B
Stanich, Peter P
Krishna, Somashekar G
Guturu, Praveen
Hinton, Alice
Conwell, Darwin L
Balasubramanian, Gokulakrishnan
Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis
title Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis
title_full Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis
title_fullStr Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis
title_full_unstemmed Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis
title_short Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis
title_sort predictors of early readmissions in hospitalized patients with gastroparesis: a nationwide analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266506/
https://www.ncbi.nlm.nih.gov/pubmed/34210906
http://dx.doi.org/10.5056/jnm20105
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