Key result
Discharge without opioids is linked to ~120% higher 30-day readmissions among IBD patients.
Cohort
Effect estimate: 2.2-fold increase
Predicting 30-day readmission in IBD patients is complex, but factors such as inflammation, infection, and outpatient follow-up compliance are associated with readmission risk.
May warrant reevaluation of opioid-sparing discharge strategies in IBD; leaves open confounding by disease severity.
OBJECTIVES: We aimed to identify the frequency and costs of, and the disease predictors and inpatient process issues that may predispose to, 30-day readmission for an inflammatory bowel disease (IBD) patient. METHODS: IBD patients admitted to an inpatient gastroenterology service were followed for a time-to-readmission analysis assessing factors associated with readmission within 30 days. RESULTS: Index admissions were more costly among those readmitted than among those not readmitted. Patients admitted with evidence of increased inflammation, infection, or obstruction or for dehydration or pain control had a higher risk of readmission. Patients treated with opioid analgesia during index admission were no less likely to be readmitted, and there was a 2.2-fold increase in readmissions when patients were discharged with no opioid analgesia. Scheduling variability and outpatient follow-up compliance were associated with readmission. CONCLUSIONS: Predicting readmission is complex. A predictive model developed to be used at discharge yielded an area under the curve of 0.757.
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Hazratjee et al. (2013) conducted a cohort in Inflammatory bowel disease. Discharge with no opioid analgesia vs. Discharge with opioid analgesia was evaluated on 30-day readmission (2.2-fold increase). Discharge with no opioid analgesia was associated with a 2.2-fold increase in 30-day readmissions among IBD patients.
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