Early readmission in patients hospitalized for ulcerative colitis: incidence and risk factors

Abstract

Objective. Early readmission rates are becoming an integral measure of the quality of care for hospitalized patients with chronic diseases. The incidence and predictors of early readmission in patients with inflammatory bowel disease (IBD) are uncertain. Risk factors for readmission over the first few weeks may differ from those that influence re-hospitalization at later time points. We examined the incidence and predictors of both 30-day and 90-day readmissions among ulcerative colitis (UC) patients. Materials and methods. A retrospective, cohort study was performed including all severe UC patients admitted to a tertiary-care hospital between January 2007 and December 2011. All-cause readmissions to the medical or surgical service within 30 and 90 days were recorded to allow the calculation of early readmission rates. We used multiple logistic regression to analyze demographic, hospital-related, general medical and IBD-specific factors as potential risk factors for readmission. Results. There were a total of 229 patients discharged following hospitalization for severe UC. The 30- and 90-day readmission rates were 11.7% and 20.5%, respectively. Forty-seven percent of early readmissions were for colectomy. In the 30-day analysis, only the presence of extensive colitis (odds ratio 3.59; 95% confidence interval [CI] 1.41–9.13) compared with left-sided disease was independently associated with readmission. Extensive colitis (3.09, 95% CI 1.33–7.08), albumin on admission (0.56, 0.31–0.99) and being admitted to a housestaff service (2.87, 95% CI 1.14–6.54), were independent predictors of readmission at 90 days. Conclusions. Early readmission is common in IBD. Independent risk factors for early readmission included extensive colitis, admission albumin, and being admitted to a housestaff service.

Key Words:

• 30-day readmission
• 90-day readmission
• inflammatory bowel disease
• risk factors
• ulcerative colitis

Acknowledgement

The Burril B. Crohn Foundation. The Mount Sinai Medical Center Advancing Clinical Excellence in Medicine (ACEM) committee.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.