Dual Antiplatelet Therapy and Arteriovenous Malformations Increase 30-Day Readmission Rates for Patients Who Undergo Endoscopic Procedures for Gastrointestinal Bleeding.

BACKGROUND AND AIMS: Gastrointestinal bleeding (GIB) is a leading cause of hospital admissions, with over 485,000 hospitalizations annually in the United States and a 30-day readmission rate of 17.4%. Despite advancements in GIB management, readmissions remain a significant burden on the health care system. This study aimed to identify risk factors for 30-day readmissions following inpatient endoscopic evaluation for GIB.

METHODS

A retrospective cohort study was conducted on patients hospitalized for GIB from November 2018 to November 2019 and from November 2020 to November 2021, excluding the COVID-19 peak period. Patients aged younger than 18 undergoing inpatient GI procedures for overt, occult, or obscure GIB were included. Demographics, hemoglobin levels, medications, procedure details, and 30-day readmissions were collected. Univariate and multivariable logistic regression analyses assessed risk factors for readmission, with subgroup analyses for procedures performed for suspected upper and lower GIB.

RESULTS

Of the 1147 patients in the final analysis, 87 (7.59%) were readmitted within 30 days for GI-related issues. Risk factors for readmission included dual antiplatelet therapy (DAPT) (21.8% vs. 11.1%, P=0.004), arteriovenous malformations (AVMs) (17.2% vs. 7.9%, P=0.003), lower hemoglobin levels before the procedure (8.7 vs. 9.1, P=0.047), and longer hospital stay (6 vs. 5 d, P=0.012). Multivariable logistic regression models identified DAPT (OR=1.96, P=0.019) and AVMs (OR=2.17, P=0.013) as individual risk factors for 30-day readmissions, after controlling for all factors.

CONCLUSIONS

DAPT use and AVMs were independently associated with increased risk of 30-day readmissions following inpatient endoscopy for GIB. These findings highlight the importance of targeted discharge planning and closer follow-up in high-risk populations to reduce readmissions and improve outcomes.