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. 2018 Feb 8;5(1):5.
doi: 10.1186/s40779-018-0153-x.

Risk Factors for 90-day Readmission in Veterans With Inflammatory Bowel disease-Does Post-Discharge Follow-Up Matter?

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Free PMC article

Risk Factors for 90-day Readmission in Veterans With Inflammatory Bowel disease-Does Post-Discharge Follow-Up Matter?

Ashish Malhotra et al. Mil Med Res. .
Free PMC article

Abstract

Background: Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions.

Methods: A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem. All-cause readmissions within 30 and 90 days were recorded to calculate early readmission rates. The multivariate logistic regression was used to identify the potential risk factors for 90-day readmission.

Results: There were 130 unique patients (56.9% with Crohn's disease and 43.1% with ulcerative colitis) with 202 IBD-related index admissions. The mean age at the time of index admission was 59.8 ± 15.2 years. The median time to re-hospitalization was 26 days (IQR 10-49), with 30- and 90-day readmission rates of 17.3% (35/202) and 29.2% (59/202), respectively. Reasons for all-cause readmission were IBD-related (71.2%), scheduled surgery (3.4%) and non-gastrointestinal causes (25.4%). The following reasons were independently associated with 90-day readmission: Crohn's disease (OR 3.90; 95% CI 1.82-8.90), use of antidepressants (OR 2.19; 95% CI 1.12-4.32), and lack of follow-up within 90 days with a primary care physician (PCP) (OR 2.63; 95% CI 1.32-5.26) or a gastroenterologist (GI) (OR 2.44; 95% CI 1.20-5.00). 51.0% and 49.0% of patients had documentation of a recommended outpatient follow-up with PCP and/or GI, respectively.

Conclusions: Early readmission in IBD is common. Independent risk factors for 90-day readmission included Crohn's disease, use of antidepressants and lack of follow-up visit with PCP or GI. Further research is required to determine if the appropriate timing of post-discharge follow-up can reduce IBD readmissions.

Keywords: Inflammatory bowel disease; Readmission rates; Veterans affairs.

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was granted for the chart review by the Institutional Review Board at the MVMC (#4552-A).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors report no conflicts of interest regarding this study.

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