Factors associated with readmission to the hospital within 30 days in patients with inflammatory bowel disease

Background: Management of inpatients with inflammatory bowel disease (IBD) requires increasing resources. We aimed to identify factors associated with hospital readmissions among individuals with IBD.

Materials & methods: We collected data from the Healthcare Cost and Utilization Project Nationwide Readmissions Database 2013. We identified individuals with index hospitalizations for IBD. Patient-specific factors, comorbidities and hospitalization characteristics were extracted for the index hospitalization. We performed logistic regression modeling to create adjusted odds ratios (ORs) for 30-day hospital readmission. Subgroup analysis was performed based on disease type and performance of surgery.

Results: We analyzed a total of 55,942 index hospital discharges; 3037 patients (7.0%) were readmitted to the hospital within 30 days. Increasing patient age (> 65: OR: 0.45; 95% CI 0.39–0.53) was associated with a decreased risk of readmission, while a diagnosis of Crohn's disease (OR: 1.09; 95% CI 1.00–1.18) and male sex (OR: 1.16; 95% CI 1.07–1.25) were associated with an increased risk of readmission. The comorbidities of smoking (OR: 1.09; 95% CI 1.00–1.19), anxiety (OR: 1.17; 95% CI 1.01–1.36) and opioid dependence (OR: 1.40; 95% CI 1.06–1.86) were associated with an increased risk of 30-day readmission. Individual hospitalization characteristics and disease complications were significantly associated with readmission. Performance of a surgery during the index admission was associated with a decreased risk of readmission (OR: 0.57; 95% CI 0.33–0.96).

Conclusion: Analyzing data from a US publicly available all-payer inpatient healthcare database, we identified patient and hospitalization risk factors associated with 30-day readmission. Identifying patients at high risk for readmission may allow for interventions during or after the index hospitalization to decrease this risk.