Department of Internal Medicine, University of Kansas School of Medicine- Wichita, Wichita, KS, USA.
Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, MO, USA.
Dis Esophagus. 2022 Feb 11;35(2). doi: 10.1093/dote/doab060.
Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory condition causing recurrent dysphagia and may predispose patients to repeated hospitalizations. We assessed temporal trends and factors affecting readmissions in patients with EoE.
Patients with primary diagnosis of EoE and/or a complication (dysphagia, weight loss, and esophageal perforation) from EoE between 2010 and 2017 were identified from the National Readmissions Database using the International Classification of Diseases codes. The primary outcome was incidence of EoE related 30-day readmission. Independent risk factors for readmissions were evaluated using multivariable logistic regression analysis. Secondary outcomes were temporal trends of readmissions and healthcare costs.
Of the 2,676 (mean age 45 ± 17.8 years, 1,667 males) index adult admissions, 2,103 (79%) patients underwent an upper endoscopy during the admission. The mean length of stay (LOS) was 3 ± 3.7 days. The 30-day readmission rate was steady at 6.8% from 2010 to 2017 and majority of the readmissions occurred by day 10 of index discharge. Age > 70 years was associated with a higher trend in 30-day readmission (P < 0.001). Longer LOS, history of smoking and the presence of eosinophilic gastroenteritis predicted readmission. Conversely, a history of foreign body impaction and upper endoscopy (including esophageal dilation) at index admission were negatively associated with readmission. Mean hospital charges significantly increased from $24,783 in 2010 to $40,922 in 2017.
Readmissions due to EoE are more likely to occur in the first 10 days of discharge and at a lesser rate when upper endoscopies are performed at the index admission.
嗜酸性食管炎（EoE）是一种慢性过敏性炎症性疾病，可导致反复吞咽困难，并可能使患者反复住院。我们评估了 EoE 患者住院再入院的时间趋势和影响因素。
从 2010 年至 2017 年，使用国际疾病分类代码，从国家再入院数据库中确定了患有 EoE 及/或 EoE 并发症（吞咽困难、体重减轻和食管穿孔）的原发性诊断的患者。主要结果是 EoE 相关 30 天再入院的发生率。使用多变量逻辑回归分析评估再入院的独立危险因素。次要结果是再入院和医疗保健费用的时间趋势。
在 2676 名（平均年龄 45±17.8 岁，1667 名男性）成年患者索引住院中，2103 名（79%）患者在住院期间接受了上内窥镜检查。平均住院时间（LOS）为 3±3.7 天。2010 年至 2017 年，30 天再入院率稳定在 6.8%，大多数再入院发生在指数出院后的第 10 天。年龄>70 岁与 30 天再入院率呈上升趋势相关（P<0.001）。较长的 LOS、吸烟史和嗜酸性胃肠炎的存在预测了再入院。相反，指数入院时的异物嵌塞和上内窥镜检查（包括食管扩张）的病史与再入院呈负相关。医院费用从 2010 年的 24783 美元显著增加到 2017 年的 40922 美元。
EoE 导致的再入院更可能发生在出院后的前 10 天，并且在指数入院时进行上内窥镜检查时再入院的可能性较小。
