title: Risk Factors for Rehospitalization Within 90 Days in Patients with Inflammatory Bowel Disease.
abstract: BACKGROUND
  Care of patients with inflammatory bowel disease (IBD) poses a significant burden to the health-care system. Repeat hospitalization in subgroups of IBD patients seems to be a large part of this issue; however, there are limited data examining the characteristics of these patients. The aim of this study was to characterize admission patterns in patients with IBD at a tertiary-care center and to identify preventable risk factors of 90-day readmission after an index IBD admission.
  
  
  METHODS
  Retrospective analysis was performed extracting data from an electronic medical record over a 2-year period.
  
  
  RESULTS
  Three hundred fifty-six patients were admitted at least once during the 2-year study period for an unplanned IBD-related reason. Of these, 48.9% were admitted once, 38.2% were admitted 2 to 4 times, and 12.9% were admitted 5 or more times during the study period. Patients with any admission within 90 days before index were excluded; n = 33. One hundred two patients had experienced a readmission by 90 days after index admission. Numerous demographic and medical factors were examined for association with readmission. The final Cox model included 3 variables: depression (HR = 1.99, 1.33-3.00), chronic pain (HR = 1.88, 1.14-3.10), and steroid use in the previous 6 months (HR = 1.33, 0.92-2.04).
  
  
  CONCLUSIONS
  Our findings suggest that patients with depression and chronic pain are at greatest risk for a readmission within 90 days after an initial IBD admission. Disease activity, represented by steroid use in the previous 6 months, was not related to readmission. Addressing these problems in the outpatient setting may reduce future hospitalizations.
authors.affiliation: Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Allegretti
authors.forename: Lawrence
authors.initials: L
authors.lastname: Borges
authors.forename: Matthew
authors.initials: M
authors.lastname: Lucci
authors.forename: Matthew
authors.initials: M
authors.lastname: Chang
authors.forename: Bonnie
authors.initials: B
authors.lastname: Cao
authors.forename: Emily
authors.initials: E
authors.lastname: Collins
authors.forename: Brian
authors.initials: B
authors.lastname: Vogel
authors.forename: Emily
authors.initials: E
authors.lastname: Arthur
authors.forename: Danielle
authors.initials: D
authors.lastname: Emmons
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Korzenik
mesh_terms: D000328:Adult; D001900:Boston; D059350:Chronic Pain; D003863:Depression; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D055815:Young Adult