Factors Associated With Hospital Admissions and Readmissions in Patients With Gastroparesis Using the Nationwide Readmission Database

Abstract

Background: Gastroparesis can be associated with severe symptoms. Health care utilization for gastroparesis has increased in part due to an increase in hospital admissions. Goals: To characterize patients admitted for gastroparesis-related symptoms and determine risk factors associated with 30-day readmissions. Study: The Nationwide Readmission Database (NRD) for the year 2014 was used to identify patients admitted to hospitals using the International Classification of Diseases (ICD)-9 code for gastroparesis as primary diagnosis or as the secondary diagnosis with first diagnosis code of a gastroparesisrelated symptom. Logistic regression was used to determine risk factors associated with 30-day readmission. Results: There were 5268 gastroparesis patients admitted with the average length of stay (LOS) of 5.4±6.6 days. Age averaged 48.9±18.1 years, 73.8% were female individuals, and 31% had diabetes. Inpatient mortality was 0.4%. The overall 30-day readmission rate was 6.2%. Longer LOS [odds ratio (OR)=1.4; 95% confidence interval (CI), 1.0-1.9], younger age, drug abuse (OR=1.6; 95% CI, 1.2-2.2), and marijuana use (OR=1.7; 95% CI, 1.0-2.7) were associated with increased risk of 30-day readmission. Female gender (P=0.083), opioid use (P=0.057), and admission to larger hospital (P=0.070) showed a trend toward higher readmission rates. Older patients, and patients with hypertension and diabetes showed lower rates of readmission. Conclusions: Use of the Nationwide Readmission Database (NRD) allows better understanding of gastroparesis admissions and readmissions. Average hospital stay was 5.4 days with 0.4% mortality rate. Overall 30-day readmission rate was 6.2%. Higher LOS, drug abuse, and marijuana use increased the 30-day readmission rate. Diabetes, hypertension, and older age were associated with lower readmissions.

Demographics of Gastroparesis Hospitalizations Through the Age Spectrum Using National Inpatient Databases

“…15 A review of the Nationwide Readmission Database (NRD) for the year 2014 of 5268 adult patients admitted with Gp showed higher admission rates in younger adults but also a lower readmission rate for patients with diabetes. 23 The most common race in the majority of admissions in both databases across different age groups was white. The next most common races were African American and Hispanic.…”

Predictors of Early Readmissions in Hospitalized Patients With Gastroparesis: A Nationwide Analysis

“…While few studies were looking at risk factors for 30-day readmission in gastroparesis patients using NRD, our study is unique in comparing 30-day all-cause and gastroparesis specific readmissions among the 3 main etiologies of gastroparesis. In a study by Shahsavari et al, 38 patients with diagnoses of both primary and secondary gastroparesis were included; marijuana use was associated with increased 30-day readmissions and diabetes with decreased 30-day readmissions. Conversely, the 30-day readmissions were not associated with marijuana use and increased in the diabetic gastroparesis group in our study.…”

Randomised study: effects of the 5‐HT4 receptor agonist felcisetrag vs placebo on gut transit in patients with gastroparesis

“…constipation, constipation‐predominant irritable bowel syndrome, gastroparesis). Patients with gastroparesis may experience acute exacerbations resulting in vomiting that may necessitate hospitalization; 6 such patients may benefit from availability of an effective parenterally administered prokinetic agent. Current prokinetic agents such as dopamine D2 antagonists, metoclopramide or domperidone, and macrolide antibiotics may be limited by adverse events, including neurological adverse events such as akathisia and tardive dyskinesia with metoclopramide; risks of prolongation of corrected QT (QT c ) interval and sudden cardiac death with domperidone; and tachyphylaxis with erythromycin 7 .…”

“…After intravenous administration in healthy volunteers and in treatment of enteral feeding intolerance in critically ill patients, felcisetrag demonstrated prokinetic activity when administered over a short term 16 . As an intravenously administered drug, felcisetrag may be useful in treating acute gastrointestinal motility disorders such as post‐operative gastrointestinal dysfunction, acute exacerbations of gastroparesis (which may result in hospitalization) 6,17 and enteral feeding intolerance in critically ill patients.…”