Predictors of Hospital Readmission in Patients Undergoing Creation of an Intestinal Ostomy

Abstract

PURPOSE:The purpose of this study was to identify predictors of 30-and 60-day hospital readmission in patients undergoing ileostomy or colostomy creation. DESIGN: A retrospective, cohort study. SAMPLE AND SETTING:The study sample comprised 258 patients who underwent ileostomy or colostomy creation from 2018 to 2021 in a suburban teaching hospital in the northeastern United States. The mean age of participants was 62.8 (SD 15.8) years; half were female and half were male. Slightly more than half 50.3% (n = 130) and 49.2% (n =127) underwent ileostomy surgery. METHODS: Data were abstracted from the electronic medical record and included the following variable categories: demographic factors, ostomy-and surgical-related factors, and ostomy-and surgical-related complications. Study outcome measures were readmission within 30 and 60 days from the index hospital admission discharge date. Predictors of hospital readmission were analyzed using bivariate testing, followed by multivariate analysis. RESULTS: Within 30 days of the index hospitalization, 49 patients were readmitted (19%), and 17 patients were readmitted (6.6%) within 60 days. For readmissions within 30 days, anatomical location of the stoma in the ileum and transverse colon as compared to descending/sigmoid colon stomas emerged as significant predictors (odds ratio [OR] 2.2; P = .036; confidence interval [CI] 1.05-4.85; OR 4.5; P = .036; CI 1.17-18.53, respectively). Within 60 days, length of the index hospitalization from 15 to 21 days as compared to shorter lengths of hospitalization emerged as the only significant predictor at this timeframe (OR 6.62; P = .018, CI 1.37-31.84). CONCLUSIONS: These factors provide a basis for identifying patients at higher risk for hospital readmission following ileostomy or colostomy surgery. For patients at higher risk for readmission following ostomy surgery, heightened surveillance and management in the immediate postoperative period may be necessary to avert potential complications.

Complications and Healthcare Costs Associated With the First Year Following Colostomy and Ileostomy Formation

“…Furthermore, early readmission rates to hospital are reported to be 20% to 30% for those following ileostomy as compared to 15.3% for those undergoing colostomy creation 13–16. A large UK study of ileostomy and colostomy patients found that chronic heart failure ( P < .05), postoperative ostomy-specific complications (bleeding: P = .02; high-output ostomy: P = .01) and loop ileostomy ( P = .01) were predictive of 30-day hospital readmission, with a recent US chart review also confirming the significant impact of anatomic location of the ostomy 12,17…”

“…[13][14][15][16] A large UK study of ileostomy and colostomy patients found that chronic heart failure (P < .05), postoperative ostomy-specific complications (bleeding: P = .02; high-output ostomy: P = .01) and loop ileostomy (P = .01) were predictive of 30day hospital readmission, with a recent US chart review also confirming the significant impact of anatomic location of the ostomy. 12,17 Despite a number of studies that describe outcomes following a new ostomy formation, few report differences in complication rates for ileostomy and colostomy patients over longer time points. Specifically, there is a paucity of studies on the economic burden associated with ostomy-related care and complications in Europe or the UK.…”