Independent predictors of 90-day readmission in patients with inflammatory bowel disease: a nationwide retrospective study

Abstract

Background and aims: There is a paucity of literature that comprehensively investigates risk factors for inflammatory bowel disease (IBD) readmissions on a national scale. In this study, we look to identify independent risk factors for readmission, including psychosocial factors, in patients admitted with a primary diagnosis of ulcerative colitis (UC) or Crohn's disease (CD).

Methods: We performed a retrospective cohort study using data from the Nationwide Readmissions Database. We identified cohorts of adult patients (n = 28 473) who required inpatient admission for UC or CD in the United States in the year 2020. Multivariate logistic regression models controlling for confounding variables were used to identify independent predictors of 90-day readmission.

Results: Patients were identified who required hospitalization for UC (n = 11 476) and CD (n = 16 997). In patients with UC, younger age, male sex, and transfusion requirement during index hospitalization were all independently predictive of increased 90-day readmission (all P < .05). Psychosocial factors predictive of readmission include alcohol use disorder, drug abuse, and poverty (all P < .05). In patients with CD, younger age and chronic pain were both predictive of increased readmissions (all P < .05). Psychosocial factors predictive of readmission include lower income quartile, uninsured status, depression, drug abuse, nicotine dependence, and opioid use disorder (all P < .05).

Conclusions: This study identifies several risk factors for readmission in patients with IBD, many of which are potentially modifiable psychosocial factors. Closer follow-up, possibly via virtual modalities, as well as alternative treatment strategies, should be considered in patients with IBD at higher risk of readmission.

Keywords: Crohn’s disease; inflammatory bowel disease; nationwide readmissions database; ulcerative colitis.