医学
内科学
炎症性肠病
胃肠病学
前瞻性队列研究
回顾性队列研究
优势比
作者
Wisam Sbeit,Tawfik Khoury,Anas Kadah,Amir Shahin,Asher Shafrir,Itai Kalisky,Wadi Hazou,Lior H Katz,Amir Mari
出处
期刊:Minerva Medica
[Edizioni Minerva Medica]
日期:2021-04-21
卷期号:112 (4): 467-473
标识
DOI:10.23736/s0026-4806.21.07442-5
摘要
Background Inflammatory bowel disease (IBD) is a set of chronic inflammatory diseases associated with significant morbidity and high hospitalization rate. IBD patients are particularly prone to re-hospitalization resulting in high medical cost and morbidity. The aim of this study is to assess laboratory and clinical predictors of re-admission in patients who were hospitalized with IBD flare. Methods a multicenter, retrospective, cross-sectional analysis included IBD patients who were admitted with disease exacerbation from January 1st 2019 to January 1st 2020 in three Israeli university hospitals (Nazareth hospital, Galilee Medical Center and Hadassah Medical Organization). Results Overall, a total of 176 hospitalizations for IBD flares were included. Seventeen patients were re-admitted within 30 days after discharge (group A), as compared to 159 patients who were not (group B). The average age was 35.3 ± 19.2 years in group A vs. 38.6 ± 16 years in group B. Eight (47.1%) and 9 (52.9%) patients had Crohn's disease (CD) and ulcerative colitis (UC) in group A as compared to 102 (64.2%) and 57 (35.9%) in group B, respectively. On univariate analysis, only the attendance to gastroenterology clinic follow-up after discharge from hospitalization due to IBD flare was significantly protective factor to with 30-days readmission (OR 0.37, 95% CI 0.13-1, P=0.05). There were no associations with the other assessed clinical and laboratory parameters and importantly IBD type (OR 1.99, 95% CI 0.74-5.34, P=0.17). Notably, there was no effect of the day of discharge white blood counts, albumin and C reactive protein (CRP) values on re-admission rates (odds ratio [OR] 1.07, 95% CI 0.96-1.20, P=0.19, OR 0.86, 95% CI 0.39-1.91, P=0.71 and OR 0.99, 95% CI 0.97-1.01, P=0.59), respectively. Conclusions attendance to out-patient gastroenterologist follow-up is the only significant protective parameter to 30-days readmission in patients with IBD. This finding highlights the vital need of adequate gastroenterological follow up of these patients after hospital discharge. Further studies are warranted to precisely define timing and role of outpatient follow-up in reducing IBD readmissions.
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