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Risk Factors for 30-day Hospital Readmission for Diverticular Hemorrhage

Rubin, Jonah N. MD, MA; Shoag, Daniel PhD; Gaetano, John N. MD; Micic, Dejan MD; Sengupta, Neil MD
Journal of Clinical Gastroenterology: Post Author Corrections: July 21, 2017
doi: 10.1097/MCG.0000000000000883
Original Article: PDF Only

Introduction:The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding.

Materials and Methods:We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage. We excluded repeat readmissions, index hospitalizations during December and those resulting in death. Our primary outcome was readmission within 30 days of index hospital discharge. Secondary outcomes of interest included medical and procedural comorbid risk factors. The data were analyzed using logistic regression analysis.

Results:In total, 29,090 index hospitalizations for diverticular hemorrhage were included. There were 3484 (12%) 30-day readmissions with recurrent diverticular hemorrhage diagnosed in 896 (3%).Index admissions with renal failure [odds ratio (OR), 1.31; 95% confidence interval (CI), 1.19-1.43], congestive heart failure (OR, 1.30; 95% CI, 1.17-1.43), chronic pulmonary disease (OR, 1.19; 95% CI, 1.09-1.29), coronary artery disease (OR, 1.12; 95% CI, 1.03-1.21), atrial fibrillation (OR, 1.12; 95% CI, 1.02-1.22) cirrhosis (OR, 1.95; 95% CI, 1.29-2.93, performance of blood transfusion (OR, 1.23; 95% CI, 1.15-1.33), and abdominal surgery (OR, 1.24; 95% CI, 1.03-1.49) had increased risk of 30-day readmission.

Conclusions:The 30-day readmission rate for diverticular hemorrhage was 12% with multiple identified comorbidities increasing readmission risk.

J.N.R., D.S.: participated in developing the study design, performing the statistical analysis, drafting, and revising of the manuscript. J.N.G., D.M., N.S.: participated in developing the study design, drafting, and revising of the manuscript.

A version of this study was previously presented at American College of Gastroenterology 2016 Conference (Rubin, J.N., Shoag, D., Gaetano, J.N., Micic, D. Risk factors for 30-day readmission in diverticular bleeding. Am J Gastroenterol. 2016; 111: S79–S82).

The authors declare that they have nothing to disclose.

Address correspondence to: Jonah N. Rubin, MD, MA, Department of Medicine, Section of Hospital Medicine, University of Chicago, 5841S, Maryland Avenue, MC 5000, Chicago, IL 60637 (e-mail: jonahrubin@uchicago.edu).

Received December 28, 2016

Accepted May 19, 2017

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