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Early Colonoscopy Does Not Affect 30-Day Readmission After Lower GI Bleeding: Insights from a Nationwide Analysis
Sachit Sharma1, Deema Sallout2, Ashu Acharya1
1Department of Internal Medicine, The University of Toledo Medical Center, Toledo, OH, USA.
Insights
Lower gastrointestinal bleeding (LGIB) has a high 30-day readmission rate of 16.4%. Early colonoscopy did not significantly impact readmission rates for patients hospitalized with LGIB.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Health Services Research
Background:
- Lower gastrointestinal bleeding (LGIB) is a frequent cause for hospital admission.
- Current management guidelines for LGIB often include colonoscopy.
- Understanding readmission patterns and the impact of interventions is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the 30-day readmission rate for patients admitted with LGIB.
- To evaluate whether early colonoscopy influences the rate of 30-day readmissions in LGIB patients.
Main Methods:
- Retrospective cohort study utilizing the Nationwide Readmission Database.
- Identification of patients admitted for LGIB using ICD-10 codes.
- Analysis of 30-day all-cause readmission rates and the effect of early colonoscopy.
Main Results:
- A total of 16.4% of over 35 million LGIB admissions resulted in 30-day readmission.
- Diverticular bleeding was the most common reason for readmission.
- Early colonoscopy (within 24 hours) did not demonstrate a significant impact on 30-day readmission rates.
Conclusions:
- Lower gastrointestinal bleeding is associated with substantial 30-day readmission rates.
- Mortality is notably higher during readmission compared to the initial hospital stay.
- Performing early colonoscopy does not appear to reduce the 30-day readmission rate for LGIB.
Introduction:
Lower gastrointestinal bleeding (LGIB) is one of the most common indications for hospital admission. The current standard of care for patients admitted with LGIB includes colonoscopy. The aims of this study are to define the rate of readmission in patients with LGIB and to determine whether early colonoscopy within the first 24 h after admission impacts the rate of readmission in these patients.
Methods:
We performed a retrospective cohort study on data obtained from the Nationwide Readmission Database and identified patients admitted with lower GI bleed using ICD-10 codes. The primary outcome was 30-day all-cause readmission, and one of our secondary outcomes was the impact of early colonoscopy on 30-day readmission.
Results:
We analyzed data from 35,790,513 patients who were admitted for LGIB in 2017. A total of 16.4% of these patients were readmitted within 30 days of discharge, with diverticular bleeding most common diagnosis for readmission. Overall, in-hospital mortality was 1.18% for index admission and 4.44% for readmission. Early colonoscopy did not impact the rate of readmission within 30 days of discharge.
Conclusion:
LGIB remains a commonly encountered in clinical practice with a high readmission rate. Mortality is significantly higher during readmission compared to index admission. Early colonoscopy did not impact the 30-day readmission rate.
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