Kidney Week

Abstract: TH-PO271

Readmission After Gastrointestinal Bleeding Hospitalization in Dialysis Patients

Session Information

• Hemodialysis: Volume, Metabolic Complications, Clinical Outcomes
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States

Yue Jiao,

• Alejos, Belen, Fresenius Medical Care, Bad Homburg, Germany

Belen Alejos,

• Wolf, Melanie, Fresenius Medical Care, Bad Homburg, Germany

Melanie Wolf,

• Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States

John W. Larkin,

• Winter, Anke, Fresenius Medical Care, Bad Homburg, Germany

Anke Winter,

• Chaudhuri, Sheetal, Fresenius Medical Care, Waltham, Massachusetts, United States

Sheetal Chaudhuri,

• Stauss-Grabo, Manuela, Fresenius Medical Care, Bad Homburg, Germany

Manuela Stauss-Grabo,

• Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States

Len A. Usvyat,

• Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States

Jeffrey L. Hymes,

• Maddux, Franklin W., Fresenius Medical Care AG & Co KGaA, Bad Homburg, Hessen, Germany

Franklin W. Maddux,

• Wheeler, David C., University College London, London, United Kingdom

David C. Wheeler,

• Stenvinkel, Peter, Dept of Renal Medicine Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

Peter Stenvinkel,

• Floege, Jürgen, University Hospital RWTH Aachen, Division of Nephrology and Clinical Immunology, Aachen, Germany

Jürgen Floege,

Group or Team Name

• On Behalf of the INSPIRE Core Group.

Background

Gastrointestinal bleeding (GIB) is the most common bleeding event in patients on chronic dialysis, and oftentimes leads to hospitalization. The outcomes associated with hospitalization for a GIB are unknown. The INSPIRE collaborative group assessed all-cause hospital readmission rates after a GIB hospitalization among a nationally representative sample of dialysis patients in the United States.

Methods

We used data from adult dialysis patients who had a GIB hospitalization between Jan-2018 to Mar-2021. GIB hospitalizations were defined from primary, secondary, or tertiary discharge diagnosis codes (Zhao et al., AHRQ 2006). All-cause readmission rate considered hospitalizations within 30 days from an index GIB hospitalization.

Results

Among a population of 405,530 patients, there were 19,663 GIB hospitalizations during follow up and 5,196 all-cause readmissions (26.4%) within 30 days of the index GIB hospitalization. On average readmissions occurred within 16.3 days of the index GIB hospitalization. Patients with a GIB hospitalization typically had one readmission event (n=4,365), yet a small proportion of patients had multiple readmissions during follow-up. Readmission rates after a GIB hospitalization were highest for younger patients between 18-44 years old, and those with an unknown or black race (Figure 1).

Conclusion

The 30-day all-cause readmission rate after a GIB hospitalization was 26%, and appeared to be highest among younger patients of a black race or those who were missing data on race. These findings act as a benchmark for the nephrology community. Future adjusted analyses are warranted to confirm the results and should consider modality and competing events of death within 30 days of an index GIB hospitalization.

Funding

• Commercial Support – Fresenius Medical Care