Dahiya Dushyant Singh, Perisetti Abhilash, Kichloo Asim, Singh Amandeep, Goyal Hemant, Rotundo Laura, Vennikandam Madhu, Shaka Hafeez, Singh Gurdeep, Singh Jagmeet, Pisipati Sailaja, Al-Haddad Mohammad, Sanaka Madhusudhan R, Inamdar Sumant
Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48601, United States.
Division of Gastroenterology, Parkview Cancer Institute, Fort Wayne, IN 46845, United States.
World J Gastrointest Pathophysiol. 2022 May 22;13(3):85-95. doi: 10.4291/wjgp.v13.i3.85.
The prevalence of Crohn's disease (CD) and ulcerative colitis (UC) is on the rise worldwide. This rising prevalence is concerning as patients with CD and UC may frequently relapse leading to recurrent hospitalizations and increased healthcare utilization.
To identify trends and adverse outcomes for 30 d readmissions for CD and UC.
This was a retrospective, interrupted trends study involving all adult (≥ 18 years) 30 d readmissions of CD and UC from the National Readmission Database (NRD) between 2008 and 2018. Patients < 18 years, elective, and traumatic hospitalizations were excluded from this study. We identified hospitalization characteristics and readmission rates for each calendar year. Trends of inpatient mortality, mean length of hospital stay (LOS) and mean total hospital cost (THC) were calculated using a multivariate logistic trend analysis adjusting for age, gender, insurance status, comorbidity burden and hospital factors. Furthermore, trends between CD and UC readmissions were compared using regression of the interaction coefficient after adjusting for age and gender to determine relative trends between the two populations. Stata Version 16 software (StataCorp, TX, United States) was used for statistical analysis and value ≤ 0.05 were considered statistically significant.
Total number of 30 d readmissions increased from 6202 in 2010 to 7672 in 2018 for CD and from 3272 in 2010 to 4234 in 2018 for UC. We noted increasing trends for 30-day all-cause readmission rate of CD from 14.9% in 2010 to 17.6% in 2018 (-trend < 0.001), CD specific readmission rate from 7.1% in 2010 to 8.2% in 2018 (-trend < 0.001), 30-day all-cause readmission rate of UC from 14.1% in 2010 to 15.7% in 2018 (-trend = 0.003), and UC specific readmission rate from 5.2% in 2010 to 5.6% in 2018 (-trend = 0.029). There was no change in the risk adjusted trends of inpatient mortality and mean LOS for CD and UC readmissions. However, we found an increasing trend of mean THC for UC readmissions. After comparison, there was no statistical difference in the trends for 30 d all-cause readmission rate, inpatient mortality, and mean LOS between CD and UC readmissions.
There was an increase in total number of 30 d readmissions for CD and UC with a trend towards increasing 30 d all-cause readmission rates.
克罗恩病（CD）和溃疡性结肠炎（UC）在全球范围内的患病率呈上升趋势。这种患病率的上升令人担忧，因为CD和UC患者可能频繁复发，导致反复住院和医疗保健利用率增加。
确定CD和UC患者30天再入院的趋势和不良结局。
这是一项回顾性中断趋势研究，纳入了2008年至2018年期间来自国家再入院数据库（NRD）的所有成年（≥18岁）CD和UC患者的30天再入院病例。本研究排除了年龄<18岁、择期手术和创伤性住院患者。我们确定了每个日历年的住院特征和再入院率。使用多变量逻辑趋势分析计算住院死亡率、平均住院时间（LOS）和平均总住院费用（THC）的趋势，并对年龄、性别、保险状况、合并症负担和医院因素进行调整。此外，在调整年龄和性别后，使用交互系数回归比较CD和UC再入院之间的趋势，以确定这两个人群之间的相对趋势。使用Stata 16软件（美国德克萨斯州StataCorp公司）进行统计分析，P值≤0.05被认为具有统计学意义。
CD患者30天再入院总数从2010年的6202例增加到2018年的7672例，UC患者从2010年的3272例增加到2018年的4234例。我们注意到CD患者30天全因再入院率呈上升趋势，从2010年的14.9%升至2018年的17.6%（P趋势<0.001），CD特异性再入院率从2010年的7.1%升至2018年的8.2%（P趋势<0.001），UC患者30天全因再入院率从2010年的14.1%升至2018年的15.7%（P趋势=0.003），UC特异性再入院率从2010年的5.2%升至2018年得5.6%（P趋势=0.029）。CD和UC再入院患者的住院死亡率和平均LOS的风险调整趋势没有变化。然而，我们发现UC再入院患者的平均THC呈上升趋势。比较后发现，CD和UC再入院患者的30天全因再入院率、住院死亡率和平均LOS趋势无统计学差异。
CD和UC患者30天再入院总数增加，30天全因再入院率呈上升趋势。
