Evidence map›Paper›PMID 38760679›Full record

ArticleBMC gastroenterology2024

Clinical and health care utilization variables can predict 90-day hospital re-admission in adults with Crohn's disease for point of care risk evaluation.

C Dziegielewski, S Gupta, J Begum, M Pugliese, J Lombardi, Kelly E, McCurdy Jd, R Sy, Saloojee N, Ramsay T and 2 more

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In one paragraph

Article in BMC gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

C DziegielewskiDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
S GuptaDepartment of Medicine, University of Toronto, Toronto, Ontario, ON, Canada.
J BegumOttawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
M PuglieseOttawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
J LombardiDepartment of Medicine, McMaster University, Hamilton, Ontario, ON, Canada.
Kelly EDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
McCurdy JdDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
R SyDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
Saloojee NDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.
Ramsay TOttawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Benchimol EiSickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.
Murthy SkDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada. smurthy@toh.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHospital re-admission for persons with Crohn's disease (CD) is a significant contributor to morbidity and healthcare costs. We derived prediction models of risk of 90-day re-hospitalization among persons with CD that could be applied at hospital discharge to target outpatient interventions mitigating this risk.

methodsWe performed a retrospective study in persons with CD admitted between 2009 and 2016 for an acute CD-related indication. Demographic, clinical, and health services predictor variables were ascertained through chart review and linkage to administrative health databases. We derived and internally validated a multivariable logistic regression model of 90-day CD-related re-hospitalization. We selected the optimal probability cut-point to maximize Youden's index.

resultsThere were 524 CD hospitalizations and 57 (10.9%) CD re-hospitalizations within 90 days of discharge. Our final model included hospitalization within the prior year (adjusted odds ratio [aOR] 3.27, 95% confidence interval [CI] 1.76-6.08), gastroenterologist consultation within the prior year (aOR 0.185, 95% CI 0.0950-0.360), intra-abdominal surgery during index hospitalization (aOR 0.216, 95% CI 0.0500-0.934), and new diagnosis of CD during index hospitalization (aOR 0.327, 95% CI 0.0950-1.13). The model demonstrated good discrimination (optimism-corrected c-statistic value 0.726) and excellent calibration (Hosmer-Lemeshow goodness-of-fit p-value 0.990). The optimal model probability cut point allowed for a sensitivity of 71.9% and specificity of 70.9% for identifying 90-day re-hospitalization, at a false positivity rate of 29.1% and false negativity rate of 28.1%.

conclusionsDemographic, clinical, and health services variables can help discriminate persons with CD at risk of early re-hospitalization, which could permit targeted post-discharge intervention.

Indexed as

Crohn DiseasePatient ReadmissionAdultFemaleHumansLogistic ModelsMaleMiddle AgedPatient Acceptance of Health CareRetrospective StudiesRisk AssessmentYoung AdultCrohn’s diseaseMultivariable modelsRe-hospitalization

Identifiers

PMID38760679
PMCPMC11102236

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.