Santiago Mafalda, Magro Fernando, Correia Luís, Portela Francisco, Ministro Paula, Lago Paula, Trindade Eunice, Dias Cláudia Camila
Center for Health Technology and Services Research (CINTESIS), Porto, Portugal.
Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal.
Therap Adv Gastroenterol. 2020 May 20;13:1756284820923836. doi: 10.1177/1756284820923836. eCollection 2020.
We aimed to describe the burden of rehospitalization in patients with inflammatory bowel disease (IBD), by evaluating rehospitalization rates, charges, and risk factors over 16 years.
We performed a retrospective analysis of all hospital discharges with a primary diagnosis of IBD in public hospitals between 2000 and 2015 in mainland Portugal from the Central Administration of the Health System (ACSS)'s national registry. We collected data on patient, clinical, and healthcare charges. We used survival analysis to estimate the rate and risk factors of IBD-related rehospitalization.
We found that 33% ( = 15,931) of the IBD-related hospitalizations corresponded to rehospitalizations, which increased by 12% over 16 years. However, IBD rehospitalization rate per 100,000 IBD patients decreased 2.5-fold between 2003 and 2015. Mean IBD-related rehospitalization charges were €14,589/hospitalization-year in 2000 and €17,548 /hospitalization-year in 2015, with total rehospitalization charges reaching €3.1 million/year by 2015. Overall, the 30-day rate of rehospitalization was 24% for Crohn's disease (CD) and 22.4% for ulcerative colitis (UC). Novel risk factors for rehospitalization include penetrating disease in CD patients {hazard ratio (HR) 1.34 [95% confidence interval (CI) 1.20-1.51], < 0.001} and colostomy in UC patients [HR 2.84 (95% CI 1.06-7.58)].
IBD-related rehospitalization should be closely monitored, and efforts to reduce its risk factors should be made to improve the quality of care and, consequently, to reduce the burden of IBD.
我们旨在通过评估16年间炎症性肠病（IBD）患者的再住院负担、再住院率、费用及风险因素。
我们对葡萄牙大陆2000年至2015年公立医院中所有以IBD为主要诊断的出院病例进行了回顾性分析，数据来自卫生系统中央管理局（ACSS）的国家登记处。我们收集了患者、临床和医疗费用的数据。我们使用生存分析来估计IBD相关再住院的发生率和风险因素。
我们发现，15,931例与IBD相关的住院病例中有33%为再住院病例，在16年间增加了12%。然而，每10万名IBD患者的IBD再住院率在2003年至2015年间下降了2.5倍。2000年IBD相关再住院的平均费用为每年每次住院14,589欧元，2015年为每年每次住院17,548欧元，到2015年再住院总费用达到每年310万欧元。总体而言，克罗恩病（CD）的30天再住院率为24%，溃疡性结肠炎（UC）为22.4%。再住院的新风险因素包括CD患者的穿透性疾病{风险比（HR）1.34[95%置信区间（CI）1.20 - 1.51]，<0.001}和UC患者的结肠造口术[HR 2.84（95%CI 1.06 - 7.58）]。
应密切监测IBD相关再住院情况，并努力降低其风险因素，以提高护理质量，从而减轻IBD的负担。
