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January 24, 2020
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Proctocolectomy doubles 30-day readmission risk vs. colectomy alone

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AUSTIN, Texas — Children with ulcerative colitis undergoing proctocolectomy had higher 30-day readmission rates as compared to colectomy alone, according to a presenter at the Crohn’s and Colitis Congress.

“Using a pediatric surgical database that included nearly 500 pediatric UC colectomies over a 6-year period, we observed that Nearly one-fifth of patients were readmitted to the hospital within 30 days of their procedure,” Matthew Egberg, MD, MD, MPH, MMSc, an assistant professor within the department of pediatrics, division of gastroenterology at the University of North Carolina School of Medicine, said during his presentation. “Following adjusted analysis, we identified that proctocolectomy compared to colectomy alone increased the risk of 30-day hospital readmission 2.5-fold.”

This retrospective study utilized the National Surgical Quality Improvement Program-Pediatric database from 2012 to 2017, from which Egberg and colleagues looked at patients younger than 18 years who underwent total abdominal colectomy. Of the 489 pediatric UC colectomies in the database, 29% (n = 141) were proctocolectomies, Egberg said.

The average annual 30-day hospital readmission rate in the overall cohort was 19.4% and after a multivariate analysis, the only independent risk factor for readmission was proctocolectomy, which carried a 2.4 times greater risk for readmission (OR = 2.4; 95% CI, 1.1-5.2).

“Children with ulcerative colitis undergoing proctocolectomy are at a high risk of hospital readmission within 30-day rates of their surgery compared to those undergoing colectomy alone,” Egberg said. “It’s important to note however that our results reflect only outcomes of the initial surgery of a staged procedure. Long-term longitudinal studies of the multi-step colectomy is required in order to evaluate comparative safety in the pediatric UC population. However, the need for ongoing research should not prevent initiating quality improvement programs that could minimize hospital readmissions today.” – by Katrina Altersitz

Reference: Egberg M, et al. Abstract 4. Presented at: Crohn’s and Colitis Congress; Jan. 23-25, 2020; Austin, Texas.

Disclosures: Egberg reports no relevant financial relationships.