Unplanned 30-Day Readmissions After Hospitalization for Irritable Bowel Syndrome.

Autor:	Ugboke JO; Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA., Uwumiro F; Internal Medicine, Our Lady of Apostles Hospital, Akwanga, NGA., Okorigba EM; Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA., Lawal RA; Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA., Okpujie V; Internal Medicine, Central Hospital Benin, Benin City, NGA., Ndulue C; Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA., Temple-Obi LO; Internal Medicine, University of Abuja Teaching Hospital, Gwagwalada, NGA., Bassey EI; Internal Medicine, College of Health Sciences, University of Uyo, Uyo, NGA., Hassan AE; Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA., Ozumba S; Family Medicine, University of Nigeria, Enugu, NGA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 14; Vol. 16 (7), pp. e64519. Date of Electronic Publication: 2024 Jul 14 (Print Publication: 2024).
DOI:	10.7759/cureus.64519
Abstrakt:	Background Irritable bowel syndrome (IBS) continues to pose significant healthcare challenges due to its broad differential diagnosis and the often extensive yet inconclusive workup. We investigated the rates and characteristics of unplanned 30-day readmissions in adult patients hospitalized with IBS. In addition, we identified factors that predict readmission within 30 days of initial discharge. Methods We analyzed the 2020 Nationwide Readmission Database. Using the International Classification of Diseases, Tenth Revision, Clinical Modification code, we identified hospitalizations in adult patients with IBS. We excluded hospitalizations for minors and planned or elective readmissions. To compare baseline characteristics between readmissions and index hospitalizations, χ2 tests were employed. We used multivariate Cox regression analyses to identify independent predictors of readmissions. Results A total of 5,729 adult hospitalizations with IBS as the primary diagnosis were discharged alive, and 638 (11.1%) readmissions occurred within 30 days. The most common diagnoses associated with readmission were noninfective gastroenteritis and colitis, sepsis, enterocolitis due to Clostridium difficile , and irritable bowel syndrome with or without diarrhea. Patients in readmissions had a mean age of 56.3 years, similar to index hospitalizations (54.5 years, p=0.093). Readmissions had a higher burden of comorbidity (Charlson comorbidity index (CMI) scores ≥3: 26.7%, 170 cases vs. 16.6%, 953 cases; p<0.001) and were mostly Medicare beneficiaries (49.5%, 316% vs. 44.9%, 2,578) compared with index hospitalizations. Readmissions had a longer mean length of stay (LOS) (5.2 vs. 3.6 days, p<0.0001), higher inpatient mortality (0.8%, 5% vs. 0.2%, 11; p=0.032), and higher mean hospital costs ($47,852 vs. $34,592; p<0.0001) compared with index admissions. Secondary diagnoses of ulcerative colitis (adjusted hazard ratio (AHR), 2.82; p<0.0001), interstitial cystitis (AHR, 5.37; p=0.007), peripheral vascular disease (AHR, 1.59; p=0.027), and discharge to short-term hospitals (AHR, 1.03; p<0.0001) were significantly associated with a higher likelihood of readmission within 30 days. Conclusion IBS readmissions have poorer outcomes than index hospitalizations. Patients with an existing history of ulcerative colitis, interstitial cystitis, and peripheral vascular disease and those discharged to short-term hospitals following index hospitalization are more likely to be readmitted within 30 days. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Ugboke et al.)
Databáze:	MEDLINE
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