US Nationwide Insight Into All-cause 30-day Readmissions following Inpatient Endoscopic Retrograde...

Area of Science:

• Gastroenterology
• Health Services Research
• Medical Informatics

Background:

• Endoscopic retrograde cholangiopancreatography (ERCP) is linked to significant patient morbidity, mortality, and hospital readmissions.
• Data on these risks within the United States healthcare system is limited.
• This study assesses post-ERCP 30-day readmission rates, their causes, and economic impact using national data.

Purpose of the Study:

• To evaluate the incidence and etiologies of 30-day readmissions following inpatient ERCP in the US.
• To identify independent risk factors associated with these readmissions.
• To analyze the financial burden of ERCP-related readmissions on the healthcare system.

Main Methods:

• Utilized the 2016 National Readmission Database to identify patients undergoing inpatient ERCP.
• Defined the primary endpoint as all-cause 30-day readmission.
• Employed multivariable logistic regression with complex survey design to determine risk factors for readmission.

Main Results:

• A total of 130,145 patients underwent ERCP, with 12.5% experiencing 30-day readmission, costing $268 million.
• Gastrointestinal etiologies accounted for 47.9% of readmissions, with nearly 40% occurring within 7 days.
• Risk factors included male gender, comorbidities, cirrhosis, Medicare insurance, and pancreatitis indications; cholecystectomy decreased readmission odds by 50%.

Conclusions:

• All-cause 30-day readmission rates post-ERCP are substantial, frequently occurring early, and represent a significant healthcare burden.
• High-volume ERCP centers demonstrated higher readmission rates compared to low-volume centers.
• Further large-scale prospective studies are necessary to investigate the influence of center procedure volume on ERCP complications and readmission rates.