The American journal of gastroenterology · 2013
Hospital readmissions in patients with inflammatory bowel disease.
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Hazratjee Nyla, Agito Markus, Lopez Rocio, Lashner Bret, Rizk Maged K
Аннотация
OBJECTIVES: We aimed to identify the frequency and costs of, and the disease predictors and inpatient process issues that may predispose to, 30-day readmission for an inflammatory bowel disease (IBD) patient.
METHODS: IBD patients admitted to an inpatient gastroenterology service were followed for a time-to-readmission analysis assessing factors associated with readmission within 30 days.
RESULTS: Index admissions were more costly among those readmitted than among those not readmitted. Patients admitted with evidence of increased inflammation, infection, or obstruction or for dehydration or pain control had a higher risk of readmission. Patients treated with opioid analgesia during index admission were no less likely to be readmitted, and there was a 2.2-fold increase in readmissions when patients were discharged with no opioid analgesia. Scheduling variability and outpatient follow-up compliance were associated with readmission.
CONCLUSIONS: Predicting readmission is complex. A predictive model developed to be used at discharge yielded an area under the curve of 0.757.
METHODS: IBD patients admitted to an inpatient gastroenterology service were followed for a time-to-readmission analysis assessing factors associated with readmission within 30 days.
RESULTS: Index admissions were more costly among those readmitted than among those not readmitted. Patients admitted with evidence of increased inflammation, infection, or obstruction or for dehydration or pain control had a higher risk of readmission. Patients treated with opioid analgesia during index admission were no less likely to be readmitted, and there was a 2.2-fold increase in readmissions when patients were discharged with no opioid analgesia. Scheduling variability and outpatient follow-up compliance were associated with readmission.
CONCLUSIONS: Predicting readmission is complex. A predictive model developed to be used at discharge yielded an area under the curve of 0.757.
Предметные рубрики MeSH
Abdominal AbscessAbdominal PainAdultAnalgesics, OpioidAppointments and SchedulesArea Under CurveBenzodiazepinesDehydrationEndoscopy, GastrointestinalFemaleHumansInflammatory Bowel DiseasesIntestinal ObstructionLength of StayMaleMiddle AgedMultivariate AnalysisPatient Care PlanningPatient CompliancePatient ReadmissionProportional Hazards ModelsTime FactorsTomography, X-Ray ComputedYoung Adult