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. 2015 Nov;21(11):2583-9.
doi: 10.1097/MIB.0000000000000537.

Risk Factors for Rehospitalization Within 90 Days in Patients with Inflammatory Bowel Disease

Jessica R Allegretti  1 , Lawrence Borges, Matthew Lucci, Matthew Chang, Bonnie Cao, Emily Collins, Brian Vogel, Emily Arthur, Danielle Emmons, Joshua R Korzenik
Affiliations

Risk Factors for Rehospitalization Within 90 Days in Patients with Inflammatory Bowel Disease

Jessica R Allegretti et al. Inflamm Bowel Dis. 2015 Nov.

Abstract

Background: Care of patients with inflammatory bowel disease (IBD) poses a significant burden to the health-care system. Repeat hospitalization in subgroups of IBD patients seems to be a large part of this issue; however, there are limited data examining the characteristics of these patients. The aim of this study was to characterize admission patterns in patients with IBD at a tertiary-care center and to identify preventable risk factors of 90-day readmission after an index IBD admission.

Methods: Retrospective analysis was performed extracting data from an electronic medical record over a 2-year period.

Results: Three hundred fifty-six patients were admitted at least once during the 2-year study period for an unplanned IBD-related reason. Of these, 48.9% were admitted once, 38.2% were admitted 2 to 4 times, and 12.9% were admitted 5 or more times during the study period. Patients with any admission within 90 days before index were excluded; n = 33. One hundred two patients had experienced a readmission by 90 days after index admission. Numerous demographic and medical factors were examined for association with readmission. The final Cox model included 3 variables: depression (HR = 1.99, 1.33-3.00), chronic pain (HR = 1.88, 1.14-3.10), and steroid use in the previous 6 months (HR = 1.33, 0.92-2.04).

Conclusions: Our findings suggest that patients with depression and chronic pain are at greatest risk for a readmission within 90 days after an initial IBD admission. Disease activity, represented by steroid use in the previous 6 months, was not related to readmission. Addressing these problems in the outpatient setting may reduce future hospitalizations.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Study inclusion and exclusion.
FIGURE 2
FIGURE 2
Disproportionate number of admissions in small subgroups of IBD patients.
FIGURE 3
FIGURE 3
Reasons for index admissions.
FIGURE 4
FIGURE 4
Reasons for ≥90-day Readmissions.
FIGURE 5
FIGURE 5
Unadjusted Kaplan–Meir curve for depression.
FIGURE 6
FIGURE 6
Unadjusted Kaplan–Meir curve for chronic pain.
See this image and copyright information in PMC

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