Inpatient endoscopy delay increases 30-day readmission rates
Inpatient endoscopy delay occurred often in a tertiary center and was a risk factor for 30-day readmission, according to a study published in Clinical Gastroenterology and Hepatology.
“[This] large study of consecutive inpatients undergoing endoscopic procedures at a tertiary care referral center demonstrated that IED occurs frequently and unfavorably prolonged [length-of-stay (LOS)] by a median of 2 days,” Chelsea C. Jacobs, DO, from department of internal medicine, University of Florida, and colleagues wrote. “Furthermore, [inpatient endoscopy delay (IED)] on initial hospitalization was identified as an independent risk factor for 30-day readmission. Our study provides comprehensive data that can be used to develop and implement potential actionable strategies to mitigate IED and improve patient care.”
Jacobs and colleagues performed a retrospective analysis of inpatient endoscopies from November 2017 to November 2019 at a tertiary center and identified 4,239 inpatients who underwent endoscopic procedures. Of these, 819 patients had experienced a delay. The number of days elapsed between anticipated vs. actual procedure day were considered an inpatient endoscopy delay. Investigators collected data from endoscopy documentation software and electronic chart review. They modeled multivariate logistic regressions to determine variables correlated with inpatient endoscopy delay and hospital re-admission.
Investigators found an inpatient endoscopy delay resulted in a median prolonged LOS of 2 days.
“Patients with IED were less likely to have an etiology identified on endoscopy (OR = 0.73; 95% CI, 0.63-0.86),” the investigators wrote. “The two most common causes for delays were poor bowel preparation (n = 218; 27%) and lack of endoscopy personnel/unit availability (n = 197; 24.4%).
According to researchers, independent predictors of IED included older age (OR = 1.1; 95% CI, 1.01-1.03), female sex (OR = 1.2; 95% CI, 1.03-1.4), use of antithrombotics (OR = 1.3; 95% CI, 1.08-1.57), opioids (OR = 1.23; 95% CI, 1.04-1.44), being on contact isolation (OR = 1.38; 95% CI, 1.09-1.75), and colonoscopy (OR = 1.5; 95% CI, 1.27-1.77).
“Conversely, inpatients admitted to a dedicated GI medicine service were less likely to have IED (OR = 0.79; 95% CI, 0.65-0.96),” Jacobs and colleagues wrote. “IED was the only independent predictor of 30-day readmission (OR = 1.22; 95%CI, 1.02-1.47).”