{"id":19807,"date":"2024-05-17T15:43:00","date_gmt":"2024-05-17T19:43:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=19807"},"modified":"2024-06-24T15:49:26","modified_gmt":"2024-06-24T19:49:26","slug":"clinical-and-health-care-utilization-variables-can-predict-90-day-hospital-re-admission-in-adults-with-crohns-disease-for-point-of-care-risk-evaluation","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/clinical-and-health-care-utilization-variables-can-predict-90-day-hospital-re-admission-in-adults-with-crohns-disease-for-point-of-care-risk-evaluation\/","title":{"rendered":"Clinical and health care utilization variables can predict 90-day hospital re-admission in adults with Crohn\u2019s disease for point of care risk evaluation"},"content":{"rendered":"

Background<\/strong> \u2014 Hospital re-admission for persons with Crohn’s disease (CD) is a significant contributor to morbidity and healthcare costs. We derived prediction models of risk of 90-day re-hospitalization among persons with CD that could be applied at hospital discharge to target outpatient interventions mitigating this risk.<\/p>\n

Methods<\/strong> \u2014 We performed a retrospective study in persons with CD admitted between 2009 and 2016 for an acute CD-related indication. Demographic, clinical, and health services predictor variables were ascertained through chart review and linkage to administrative health databases. We derived and internally validated a multivariable logistic regression model of 90-day CD-related re-hospitalization. We selected the optimal probability cut-point to maximize Youden’s index.<\/p>\n

Results<\/strong> \u2014 There were 524 CD hospitalizations and 57 (10.9%) CD re-hospitalizations within 90 days of discharge. Our final model included hospitalization within the prior year (adjusted odds ratio [aOR] 3.27, 95% confidence interval [CI] 1.76-6.08), gastroenterologist consultation within the prior year (aOR 0.185, 95% CI 0.0950-0.360), intra-abdominal surgery during index hospitalization (aOR 0.216, 95% CI 0.0500-0.934), and new diagnosis of CD during index hospitalization (aOR 0.327, 95% CI 0.0950-1.13). The model demonstrated good discrimination (optimism-corrected c-statistic value 0.726) and excellent calibration (Hosmer-Lemeshow goodness-of-fit p-value 0.990). The optimal model probability cut point allowed for a sensitivity of 71.9% and specificity of 70.9% for identifying 90-day re-hospitalization, at a false positivity rate of 29.1% and false negativity rate of 28.1%.<\/p>\n

Conclusions<\/strong> \u2014 Demographic, clinical, and health services variables can help discriminate persons with CD at risk of early re-hospitalization, which could permit targeted post-discharge intervention.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background \u2014 Hospital re-admission for persons with Crohn’s disease (CD) is a significant contributor to morbidity and healthcare costs. We derived prediction models of risk of 90-day re-hospitalization among persons with CD that could be applied at hospital discharge to target outpatient interventions mitigating this risk. Methods \u2014 We performed a retrospective study in persons […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,42,62],"migration-helper-qa-sample-set":[],"class_list":["post-19807","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-chronic-diseases-and-multimorbidity","topic-health-services-research"],"acf":{"citation":"Dziegielewski C, Gupta S, Begum J, Pugliese M, Lombardi J, Kelly E, McCurdy J, R Sy, Saloojee N, Ramsay T, Benchimol E, Murthy S.\u00a0BMC Gastroenterol<\/em>. 2024; 24(1):172. Epub 2024 May 17.","source_url":"https:\/\/doi.org\/10.1186\/s12876-024-03226-7","ices_scientist":[1174,1317],"site":[6734],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Clinical and health care utilization variables can predict 90-day hospital re-admission in adults with Crohn\u2019s disease for point of care risk evaluation<\/title>\n<meta name=\"description\" content=\"Background \u2014 Hospital re-admission for persons with Crohn's disease (CD) is a significant contributor to morbidity and healthcare costs. 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