Factors Associated With Readmissions and Outcomes of Patients Hospitalized for Inflammatory Bowel Disease

Nguyen, Geoffrey C.; Bollegala, Natasha; Chong, Christopher A K Y

doi:10.1016/j.cgh.2014.02.042

Cited by 42 publications

(41 citation statements)

References 24 publications

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“…We are unable to adjust for volume of IBD-related surgery performed at each hospital, a factor that may be significant in CD-related postoperative outcomes. 24 Finally, complications are limited to the 30-day postoperative period, and complications including disease complications beyond this are not captured in the ACS NSQIP database.…”

Section: Discussionmentioning

confidence: 99%

African Americans and Short-Term Outcomes after Surgery for Crohn’s Disease: An ACS-NSQIP Analysis

Arsoniadis

Melton

et al. 2016

ECCOJC

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Background: Previous reports on racial disparities in the treatment of Crohn's disease [CD] [smoking], race remained a statistically significant factor in postoperative complication rate. Only after additional adjustment was made for comorbidities and American Society of Anesthesiologists class did race lose significance within our model. Conclusion: African Americans experience a greater amount of postoperative complications following surgery for Crohn's disease. Preoperative disease management, addressing smoking status and control of comorbid disease are important factors in addressing the racial disparities in the surgical treatment of Crohn's disease.

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Section: Discussionmentioning

confidence: 99%

African Americans and Short-Term Outcomes after Surgery for Crohn’s Disease: An ACS-NSQIP Analysis

Arsoniadis

Melton

et al. 2016

ECCOJC

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“…2,3 In addition, a Canadian study demonstrated that pediatric patients with IBD are at greater risk for hospital readmission compared with older patients. 4 These trends are cause for concern to both patients and payers, as hospitalization of pediatric patients with IBD has been associated with a significant cost burden 5–7 and hospitalization has been associated with decreased health-related quality of life in other populations of children with chronic diseases. 8 …”

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confidence: 99%

The Burden of Hospital Readmissions among Pediatric Patients with Inflammatory Bowel Disease

Barnes

Kochar

Long

et al. 2017

The Journal of Pediatrics

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Objective To evaluate the burden and predictors of hospital readmissions among pediatric patients with inflammatory bowel disease using the Nationwide Readmissions Database. Study design We performed a retrospective cohort study using 2013 Nationwide Readmissions Database. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify patients <18 years with diagnoses of ulcerative colitis (UC) or Crohn disease (CD). Demographic factors and details of hospitalizations were evaluated using survey procedures in SAS v 9.4 (SAS Institute, Cary, North Carolina). Multivariable logistic regression was used to estimate ORs and 95% CIs of readmission. Results Among 2733 hospitalizations (63% CD, 37% UC), 611 (22%) patients were readmitted within 90 days of the index hospitalization. Readmission resulted in weighted estimates of 11 440 excess days of hospitalization and total charges of over $107 million. For CD, male sex (aOR 1.36, 95% CI 1.03–1.81) and co-existing anxiety or depression (aOR 1.89, 95% CI 1.06–3.40) were associated with increased readmissions, while patients who underwent surgery had decreased readmissions (aOR 0.40, 95% CI 0.24–0.65). In patients with UC, and index admission of >7 days was associated with increased readmissions (aOR 1.69, 95% CI 1.09–2.62). Conclusions Readmission occurs frequently in children with inflammatory bowel disease and is associated with significant cost and resource burdens. Among patients with CD, psychiatric comorbidities such as anxiety and depression are apparent drivers of readmission.

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“…Studies have shown improved outcomes and decreased readmissions in high volume IBD centers compared to lower volume hospitals (4, 16). Only 9% of surveyed fellows expressed an interest in pursuing an advanced IBD fellowship, but 34% answered they would like to pursue a career in IBD in the academic or non-academic setting.…”

Section: Discussionmentioning

confidence: 99%

State of Adult Trainee Inflammatory Bowel Disease Education in the United States

Cohen

Ananthakrishnan

et al. 2016

Inflammatory Bowel Diseases

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Introduction The fundamentals of inflammatory bowel disease (IBD) education begin during gastroenterology (GI) fellowship training. We performed a survey of GI fellowship program directors (PD) and trainees with the aim to further examine the current state of IBD training in the United States. Materials and Methods A 15-question PD survey and 19-question trainee survey was performed using an online platform. Results Surveys were completed by 43/161 (27%) PDs and 160 trainees. All trainee years were equally represented. A significant proportion of trainees was unsure or felt their inpatient (32%) or outpatient (43%) training was inadequate. Only 28% of trainees were satisfied with their current level of IBD exposure during training. Fewer than half the trainees reported comfort in the management of pouch or stoma issues, the pregnant IBD patient, or post-operative management. The proportion of PDs viewing a competency as essential for trainee education strongly correlated with trainee comfort in that area (Pearson’s rho = 0.793, p<0.01). In multivariate logistic regression, monthly IBD didactics was the only variable independently associated with satisfaction with current level of training (OR 4.1, 95% CI 1.9–9.0). Conclusions Over one-third of participating GI trainees did not feel “confident” or “mostly comfortable” with their level of IBD training, with varying comfort regarding different competencies in IBD management. These findings suggest that specific areas of IBD training may require additional focus during training and can provide the basis for the development of an IBD core competency curriculum.

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Factors Associated With Readmissions and Outcomes of Patients Hospitalized for Inflammatory Bowel Disease

Cited by 42 publications

References 24 publications

African Americans and Short-Term Outcomes after Surgery for Crohn’s Disease: An ACS-NSQIP Analysis

African Americans and Short-Term Outcomes after Surgery for Crohn’s Disease: An ACS-NSQIP Analysis

The Burden of Hospital Readmissions among Pediatric Patients with Inflammatory Bowel Disease

State of Adult Trainee Inflammatory Bowel Disease Education in the United States

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