title: Predictors of Hospital Readmissions for Ulcerative Colitis in the United States: A National Database Study.
abstract: Early readmissions are important indicators of quality of care. Limited data exist describing hospital readmissions in ulcerative colitis (UC). The aim of this study was to describe unplanned, 30-day readmissions among adult UC patients and to assess readmission predictors.
  
  
  
  We analyzed the 2013 United States National Readmission Database and identified UC admissions using administrative codes in patients from 18 to 80 years of age. Our primary outcome was a 30-day, unplanned readmission rate. We used chi-square tests, t tests, and Wilcoxon rank-sum tests for descriptive analyses and survey logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations with readmissions adjusting for confounders.
  
  
  
  Among 26,094 hospitalizations with a primary UC diagnosis, there were 2757 (10.6%) 30-day, unplanned readmissions. The most common readmission diagnoses were reasons related to UC (58%), complications of surgical procedures/medical care (5.5%), Clostridium difficile (4.8%), and septicemia (4.3%). In multivariable analysis, length of stay ≥7 days (aOR 1.54, 95% CI, 1.24-1.90), not having an endoscopy (aOR 1.20, 95% CI, 1.04-1.38), and depression (aOR 1.40, 95% CI, 1.16-1.66) were significantly associated with readmission. 58.2% of readmissions had at least one of these factors. Patients were also less likely to be admitted if they were women or had self-pay payer status. Having a colectomy did not significantly increase readmissions (aOR 1.14, 95% CI, 0.86-1.52).
  
  
  
  On a national level, 1 in 10 hospitalizations for UC was followed by an unplanned readmission within 30 days. Not having an endoscopy on the index hospitalization and depression were independently associated with readmissions. Further studies should examine if strategies that address these predictors can decrease readmissions.
authors.affiliation: *Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; †The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; and ‡Division of Gastroenterology and Nutrition, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Priti
authors.initials: P
authors.lastname: Poojary
authors.forename: Aparna
authors.initials: A
authors.lastname: Saha
authors.forename: Kinsuk
authors.initials: K
authors.lastname: Chauhan
authors.forename: Priya
authors.initials: P
authors.lastname: Simoes
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Sands
authors.forename: Judy
authors.initials: J
authors.lastname: Cho
authors.forename: Thomas
authors.initials: T
authors.lastname: Ullman
authors.forename: Girish
authors.initials: G
authors.lastname: Nadkarni
authors.forename: Ryan
authors.initials: R
authors.lastname: Ungaro
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000628:therapy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D014481:United States