Factors Associated With Inpatient Endoscopy Delay and its Impact on Hospital Length-of-Stay and 30-Day Readmission
| Autor: | Dennis Yang, Michael Ladna, Chelsea Jacobs, Ishaan Madhok, Francesca M. Gesiotto, Walid Khan, Vikas J. Patel, Johnny Jaber, Peter V. Draganov, Tony S. Brar, Haley Podeschi, Nabeel Moon, Nicole C. Ruiz, Brett Styskel, April A Mathews, Sandeep A. Ponniah |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Logistic regression Patient Readmission Endoscopy Gastrointestinal Interquartile range Risk Factors medicine Humans Risk factor Aged Retrospective Studies Hospital readmission Inpatients Hepatology medicine.diagnostic_test business.industry Gastroenterology Odds ratio Length of Stay Middle Aged Confidence interval Hospitals Endoscopy Emergency medicine Etiology Female business |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 19(12) |
| ISSN: | 1542-7714 |
| Popis: | Inpatient endoscopy delay (IED) negatively impacts the delivery of high-quality care. We aimed to identify factors associated with IED and evaluate its effect on hospital length-of-stay (LOS) and readmission.This was a retrospective analysis of all inpatient endoscopies performed between November 2017 and November 2019 at a tertiary care center. IED was defined as the number of days elapsed between anticipated versus actual procedure day. Data were extracted from the endoscopy documentation software and via electronic chart review. Multivariate logistic regressions were modeled to determine variables associated with IED and hospital readmission.A total of 4239 inpatients (mean age, 58.3 years; 50.3% women) underwent endoscopic procedures during the study period of which 819 patients (19.3%) experienced a delay. IED resulted in a median prolonged LOS of 2 days (interquartile range, 1-2 days). Patients with IED were less likely to have an etiology identified on endoscopy (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.63-0.86; P.001). The 2 most common causes for delays were poor bowel preparation (n = 218; 27%) and lack of endoscopy personnel/unit availability (n = 197; 24.4%). Independent predictors of IED included: older age (OR, 1.1; 95% CI, 1.01-1.03; P = .03), female sex (OR, 1.20; 95% CI, 1.03-1.40; P = .02), use of antithrombotics (OR, 1.30; 95% CI, 1.08-1.57; P = .006), opioids (OR, 1.23; 95% CI, 1.04-1.44; P = .012), being on contact isolation (OR, 1.38; 95% CI, 1.09-1.75; P = .008), and colonoscopy (OR, 1.50; 95% CI, 1.27-1.77; P.001). Conversely, inpatients admitted to a dedicated GI medicine service were less likely to have IED (OR, 0.79; 95% CI, 0.65-0.96; P = .02). IED was the only independent predictor of 30-day readmission (OR, 1.22; 95% CI, 1.02-1.47; P = .03).IED occurred frequently, unfavorably prolonged LOS, and was an independent risk factor for 30-day readmission. We provide a comprehensive analysis of actionable variables associated with IED that can be targeted to improve inpatient endoscopy delivery. |
| Databáze: | OpenAIRE |
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