Risk factors for readmission in hospitalized patients with inflammatory bowel disease: a retrospective cohort study

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract characterized by complex clinical manifestations and a high rate of hospital readmission, imposing a substantial burden on patients and healthcare systems. Clarifying the clinical characteristics of IBD patients and identifying risk factors for readmission are crucial for optimizing clinical management strategies.

To analyze the clinical characteristics of hospitalized IBD patients and identify independent risk factors associated with readmission.

This single-center retrospective study included 120 IBD patients admitted to the Department of Gastroenterology at Beijing Friendship Hospital, Capital Medical University, between January 2019 and January 2023. Demographic data, clinical symptoms, laboratory parameters, endoscopic and imaging findings, treatment regimens, and follow-up outcomes (6-12 months) of each patient were collected. Univariate analyses were performed to screen potential factors associated with readmission, followed by multivariate logistic regression to identify independent predictors.

The mean age of the included patients was 42.5±12.3 years, with 56.7% being male. Abdominal pain (85.0%) and diarrhea (81.7%) were the most prevalent symptoms. Among the cohort, 51 patients (42.5%) were diagnosed with Crohn's disease (CD) and 69 (57.5%) with ulcerative colitis (UC). During follow-up, 38 patients (31.7%) experienced readmission, with a mean interval of 3.2±1.5 months. Multivariate analysis identified severe disease (OR = 3.85, 95% CI: 1.92-7.72), presence of complications (e.g., intestinal obstruction, perforation, or intra-abdominal abscess; OR = 3.22, 95% CI: 1.65-6.30), and C-reactive protein (CRP) levels ≥2 times the upper limit of normal (OR = 2.98, 95% CI: 1.51-5.88) as independent risk factors for readmission. Conversely, treatment with biologics was protective factor (OR = 0.35, 95% CI: 0.16-0.76). The readmission rate was 58.3% in patients with severe disease versus 8.3% in those with mild disease, while only 10.0% of biologic-treated patients were readmitted, significantly lower than those receiving aminosalicylates (37.8%), corticosteroids (34.4%), or immunomodulators (30.4%).

Hospitalized IBD patients are predominantly middle-aged males, with clinical features varying by disease subtype. Disease severity, complications, and elevated CRP levels significantly increase the risk of readmission, whereas biologic therapy is associated with a markedly reduced risk. Integrating these factors into clinical decision-making enables precision assessment and individualized interventions to improve outcomes and reduce hospital readmissions.