Stomach

69 - Predictors of 30-Day Readmission in Patients Admitted With Gastroparesis: Nationwide Analysis

Wednesday, October 10
9:10 AM - 9:20 AM
Location: Terrace Ballroom 2-3 (level 400)

Category: Stomach
Ravi Pavurala, MD1, Alice Hinton, PhD2, Peter P. Stanich, MD1, Somashekar G. Krishna, MD, MPH1, Darwin Conwell, MD, MS1, Gokulakrishnan Balasubramanian, MD2
1The Ohio State University Wexner Medical Center, Columbus, OH; 2The Ohio State University, Columbus, OH

Introduction: Gastroparesis is characterized by chronic upper gastrointestinal symptoms in the absence of mechanical obstruction. Often, these symptoms are difficult to control and lead to nutritional and metabolic derangements with prolonged hospitalization. We sought to determine gastroparesis-related healthcare utilization by etiology and predictors of 30-day readmission.

Methods: We identified all adults (age ≥18 years) admitted to hospital with a principal diagnosis of gastroparesis from the 2014 Nationwide Readmission Database. Healthcare utilization outcomes of patients with gastroparesis secondary to diabetes, post-surgical and idiopathic were compared. Further, a multivariate logistic regression model was fit to identify significant predictors of 30-day readmission.

Results: A total of 12,689 patients were hospitalized with gastroparesis. (Table 1) The most common forms of gastroparesis were idiopathic (64.2%), followed by diabetic (30.4%) and post-surgical causes (5.4%). 30-day readmission rates were significantly higher among diabetic gastroparesis compared to that of idiopathic and post-surgical gastroparesis (29.33% vs 24.26% vs 22.55%, p = 0.002). Conversely, patients with post-surgical gastroparesis had higher mortality than that of diabetic and idiopathic gastroparesis, in the calendar year (3.6% vs 2.57% vs 1.61 %, p=0.04).On multivariate analysis, presence of diabetes mellitus (Odds Ratio (OR) 1.17, 95% Confidence Interval (CI) 1.00, 1.37), male gender (OR 1.20, 95% CI 1.04, 1.41), Elixhauser score ≥3 (OR 1.52, 95% CI 1.29, 1.78), chronic pain syndrome (OR 1.47, 95% CI 1.16, 1.86), need for gastrostomy tube (OR 1.97, 95% CI 1.12, 3.48), and parenteral nutrition (OR 1.65, 95% CI 1.19, 2.28) were associated with increased risk of 30-day readmission. (Table 2)

Discussion: Patients with gastroparesis are frequently readmitted within 30 days, with several factors increasing this risk including diabetes, chronic pain syndrome and need for enteral/parenteral nutrition. We also noted an increased mortality risk among patients with post-surgical gastroparesis. Future work should focus on improving outcomes in these high-risk cohorts.

Table 1. Characteristics of Patients with Gastroparesis undergoing Hospitalization during 2014: Nationwide Readmission Database
Table 2. Predictors of 30-day Readmissions in Patients with Gastroparesis: Multivariate Analysis

Disclosures:
Ravi Pavurala indicated no relevant financial relationships.
Alice Hinton indicated no relevant financial relationships.
Peter Stanich indicated no relevant financial relationships.
Somashekar Krishna indicated no relevant financial relationships.
Darwin Conwell indicated no relevant financial relationships.
Gokulakrishnan Balasubramanian indicated no relevant financial relationships.

Ravi Pavurala

Assistant Professor
Division of Hospital Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center
Columbus, Ohio

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