Angiotensin-Converting Enzyme Inhibitor (ACEI) and Angiotensin Receptor Blocker (ARB) Use are Associated With...

Area of Science:

• Gastroenterology
• Cardiology
• Pharmacology

Background:

• High ileostomy output is a frequent cause of hospital readmission.
• Sodium loss activates the renin-angiotensin-aldosterone system (RAAS) as a compensatory mechanism.
• Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are common hypertension treatments.

Purpose of the Study:

• To investigate if concurrent use of ACEI/ARB increases readmission risk after new ileostomy creation.
• To evaluate the impact of RAAS inhibition on post-ileostomy complications.

Main Methods:

• Retrospective study of 540 patients undergoing ileostomy creation (2009-2022).
• Primary outcomes: 30-day hospital readmission and ED visits.
• Analysis included ACEI/ARB use, comorbidities, and discharge medications.

Main Results:

• 41.9% of patients experienced readmission or ED visit within 30 days.
• Patients discharged on ACEI/ARB showed significantly higher readmission rates (37.4% vs 25.5%, P = .005).
• Use of additional antihypertensives also correlated with increased readmission risk (37.2% vs 17.3%, P = .006).

Conclusions:

• RAAS inhibition is associated with an elevated risk of hospital readmission post-ileostomy.
• Individualized care plans are crucial for hypertensive patients undergoing ileostomy.
• Consider earlier use of antimotility agents or IV rehydration to mitigate risks.