Abstract: FR-PO829
Readmission After Gastrointestinal Bleeding Hospitalization Type in Dialysis Patients
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States
- Alejos, Belen, Fresenius Medical Care, Bad Homburg, Germany
- Wolf, Melanie, Fresenius Medical Care, Bad Homburg, Germany
- Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States
- Winter, Anke, Fresenius Medical Care, Bad Homburg, Germany
- Chaudhuri, Sheetal, Fresenius Medical Care, Waltham, Massachusetts, United States
- Stauss-Grabo, Manuela, Fresenius Medical Care, Bad Homburg, Germany
- Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
- Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care AG & Co KGaA, Bad Homburg, Hessen, Germany
- Wheeler, David C., University College London, London, United Kingdom
- Stenvinkel, Peter, Dept of Renal Medicine Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Floege, Jürgen, University Hospital RWTH Aachen, Division of Nephrology and Clinical Immunology, Aachen, Germany
Group or Team Name
- On Behalf of the INSPIRE Core Group.
Background
The incidence of gastrointestinal bleeding (GIB) is high in the dialysis population. GIB episodes frequently lead to hospitalization, yet associated outcomes have not been defined and may differ by GIB type. The INSPIRE group aimed to define the all-cause hospital readmission rates after an index GIB hospitalization considering the type of GIB (upper or lower).
Methods
We used data on adult chronic dialysis patients who were hospitalized for a GIB in the United States during Jan-2018 to Mar-2021. GIB hospitalizations were identified from ICD discharge diagnosis codes (Zhao et al., AHRQ 2006). All-cause readmission rate considered events within 30 days from an index GIB hospitalization by GIB type. Index GIB hospitalizations with an unspecified location for the GIB were not included in the analysis of GIB types.
Results
In a population of 405,530 patients, 19,663 GIB hospitalizations occurred. Overall, there was a 26.4% all-cause 30-day readmission rate after an index GIB hospitalization. Readmission rate was consistent by GIB types at 26.4% for upper and 26.0% for lower GIB hospitalizations. Readmission rates after a GIB hospitalization were highest among patients 18-44 years old for all GI bleed types (Figure 1). Readmission rates after an upper GIB were higher for females, patients ≥75 years old, and those with a black and other race. Readmission after a lower GIB was most common among patients with an Asian and unknown race.
Conclusion
All-cause readmission rate after a GIB hospitalization was about 26% for all GIB types. Readmission rates were higher (>30%) among younger patients for upper and lower GIBs. Sex-dependent differences in readmission rates were observed after an upper-GIB hospitalization, as well as differences by age and race in readmission rates after an upper- and lower-GIB hospitalization. Further adjusted analyses are needed to confirm these findings and understand the disparities in outcomes.
Funding
- Commercial Support – Fresenius Medical Care