Trends and predictors of 30-day readmissions in subjects with eosinophilic esophagitis: results from a national cohort.

Autor: Srinivasan S; Department of Internal Medicine, University of Kansas School of Medicine- Wichita, Wichita, KS, USA.; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA., Sundaram S; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA., Kennedy KF; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA.; Department of Biostatistics, St Luke's Medical Center, Kansas City, MO, USA., Kohli DR; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA., Emura F; Department of GI Endoscopy, Emura Center Latino America, Bogota D.C., Colombia.; Division of Gastroenterology, Universidad de La Sabana, Chia, Colombia., Sharma P; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA.; Division of Gastroenterology, University of Kansas School of Medicine, Kansas City, KS, USA., Desai M; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA.; Division of Gastroenterology, University of Kansas School of Medicine, Kansas City, KS, USA.
Jazyk: angličtina
Zdroj: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2022 Feb 11; Vol. 35 (2).
DOI: 10.1093/dote/doab060
Abstrakt: Background: Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory condition causing recurrent dysphagia and may predispose patients to repeated hospitalizations. We assessed temporal trends and factors affecting readmissions in patients with EoE.
Methods: Patients with primary diagnosis of EoE and/or a complication (dysphagia, weight loss, and esophageal perforation) from EoE between 2010 and 2017 were identified from the National Readmissions Database using the International Classification of Diseases codes. The primary outcome was incidence of EoE related 30-day readmission. Independent risk factors for readmissions were evaluated using multivariable logistic regression analysis. Secondary outcomes were temporal trends of readmissions and healthcare costs.
Results: Of the 2,676 (mean age 45 ± 17.8 years, 1,667 males) index adult admissions, 2,103 (79%) patients underwent an upper endoscopy during the admission. The mean length of stay (LOS) was 3 ± 3.7 days. The 30-day readmission rate was steady at 6.8% from 2010 to 2017 and majority of the readmissions occurred by day 10 of index discharge. Age > 70 years was associated with a higher trend in 30-day readmission (P < 0.001). Longer LOS, history of smoking and the presence of eosinophilic gastroenteritis predicted readmission. Conversely, a history of foreign body impaction and upper endoscopy (including esophageal dilation) at index admission were negatively associated with readmission. Mean hospital charges significantly increased from $24,783 in 2010 to $40,922 in 2017.
Conclusion: Readmissions due to EoE are more likely to occur in the first 10 days of discharge and at a lesser rate when upper endoscopies are performed at the index admission.
(© The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze: MEDLINE
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