The Red Section

Am J Gastroenterol 2013; 108:1024–1032; doi:10.1038/ajg.2012.343

Hospital Readmissions in Patients With Inflammatory Bowel Disease

Nyla Hazratjee MD1, Markus Agito MD2, Rocio Lopez MS3, Bret Lashner MD, MPH4 and Maged K Rizk MD4

  1. 1Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2Department of Internal Medicine, Akron General Hospital, Akron, Ohio, USA
  3. 3Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
  4. 4Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA

Correspondence: Maged K. Rizk, MD, Cleveland Clinic, 9500 Euclid Avenue, A30, Cleveland, Ohio 44195, USA. E-mail: doctorrizk@gmail.com

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Abstract

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.