Rehospitalization common among patients admitted for constipation

WASHINGTON — More than one-third of patients hospitalized for constipation are readmitted within 90 days, and clinical rather than demographic factors were key predictors of readmission, according to research presented at Digestive Disease Week.

“Constipation affects approximately 12% to 19% of North Americans,” Anwar Dudekula, MD, MS, of Saint Peters University Hospital in New Jersey, said during his presentation. According to an analysis in 2004, “the direct cost was approximately $1.6 billion. The mean annual cost of diagnostic studies for constipation have been shown to approach approximately $3,000 per patient.” Indirect costs include missed work and school days, restricted activity and impairment at work, he added.

Further, he said the burden of constipation on hospital systems is significant, with 7.95 million annual ambulatory office visits between 2001 and 2004. Emergency department visits for constipation increased by 41.5% between 2006 and 2011, and the average cost per patient increased by 56.4%. Yet another analysis showed that admissions for constipation, average charges per hospital discharge, and total costs all increased substantially between 1997 and 2010.

Therefore, to assess the prevalence, timing and predictors of readmissions among adult patients hospitalized for constipation in the U.S., Dudekula and colleagues analyzed data from the Nationwide Readmissions Database. They identified 10,361 sample participants that represented 24,026 patients hospitalized for constipation in 2013, about 32% of whom were readmitted. Overall, 2% of those readmissions were constipation-related, 26% were for unrelated conditions, 15% were within 30 days of discharge, 21% were within 60 days and 24% were within 90 days.

The following factors were identified as significant predictors of rehospitalization:

Male sex (HR = 1.2; 95% CI, 1-1.4);

Unfavorable discharge (HR = 1.2; 95% CI, 1-1.4);

Treatment in an urban teaching hospital (HR = 1.2; 95% CI, 1-1.4);

Elixhauser comorbidity index score of 3 or higher (HR = 1.5; 95% CI, 1.3-1.9);

Gastroparesis diagnosis (HR = 2; 95% CI, 1.5-2.7); and

Depression diagnosis (HR = 1.2; 95% CI, 1-1.5).

“The study identified the clinical factors and the demographic factors which are associated with readmissions, and we feel that the efforts to treat the underlying clinical conditions are necessary to reduce the burden of constipation in the United States,” Dudekula concluded. – by Adam Leitenberger

Reference:

Dudekula A, et al. Abstract 260. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosures: Dudekula reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.