Characteristics and Hospital Outcomes of 1403 Patients Hospitalized at Community Hospitals With Ankylosing Spondylitis.

HCA healthcare journal of medicine Pub Date : 2024-03-29 eCollection Date: 2024-01-01 DOI:10.36518/2689-0216.1600
Se Won Lee, Carol Elsakr, Jonathan Holt, Napatkamon Ayutyanont
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Abstract

Background: In this study, we aimed to assess the hospital course, outcomes after hospitalization, and predictors of outcomes in patients with ankylosing spondylitis (AS).

Methods: We included 1403 patients with AS between 2016 and 2021 who were identified using International Classification of Disease (ICD) codes from a large for-profit healthcare system database. Demographics and clinical characteristics were compared between those who had a favorable outcome, defined as being discharged to home without readmission within 3 months of discharge, versus those who had an unfavorable outcome. A stepwise logistic regression was used to identify demographic and clinical characteristics associated with home discharge and readmission.

Results: The mean age for all AS patients was 56.06 ± 17.01 years, which was younger in the favorable outcome group, and 82.47% of patients were discharged to home after the average length of stay of 3.72 ± 4.09 days, also shorter in the favorable outcome group. Of 1403 patients, 37.56% were readmitted within 3 months of discharge, at a lower rate in the group with home discharge. Opioids were the most commonly used medication during hospitalization (67.07%), prescribed at a lower rate in the favorable outcome group. Medical coverage by Medicare and Medicaid, fall at admission, hospital-acquired anemia, steroid, acetaminophen, muscle relaxant use, and an increased dose of morphine milligram equivalent at discharge were significantly associated with decreased odds of home discharge. Surgical procedures during admission, gastrointestinal complications, discharge to inpatient rehabilitation units, and use of benzodiazepine were associated with an increased risk of readmission within 3 months.

Conclusion: Recognizing factors that put patients with AS at risk of unfavorable outcomes is useful information to improve patient care during hospitalization.

在社区医院住院的 1403 名强直性脊柱炎患者的特征和住院治疗结果。
背景在这项研究中,我们旨在评估强直性脊柱炎(AS)患者的住院过程、住院后的预后以及预后的预测因素:我们纳入了2016年至2021年间的1403名强直性脊柱炎患者,这些患者是通过大型营利性医疗系统数据库中的国际疾病分类(ICD)代码确定的。比较了出院后3个月内无再入院的良好预后患者与出院后3个月内无再入院的不良预后患者的人口统计学特征和临床特征。采用逐步逻辑回归法确定与出院回家和再入院相关的人口统计学和临床特征:所有强直性脊柱炎患者的平均年龄为(56.06±17.01)岁,结果良好组的患者更年轻,82.47%的患者在平均住院时间(3.72±4.09)天后出院回家,结果良好组的患者住院时间也更短。在1403名患者中,37.56%的患者在出院后3个月内再次入院,出院回家组的入院率较低。阿片类药物是住院期间最常用的药物(67.07%),在疗效好的组别中使用率较低。医疗保险(Medicare)和医疗补助(Medicaid)的医疗覆盖范围、入院时的跌倒、医院获得性贫血、类固醇、对乙酰氨基酚、肌肉松弛剂的使用以及出院时吗啡毫克当量剂量的增加与出院回家的几率降低有显著关系。入院时的外科手术、胃肠道并发症、出院后转入住院康复病房以及使用苯二氮卓类药物与3个月内再次入院的风险增加有关:结论:识别使强直性脊柱炎患者面临不利后果风险的因素是改善住院期间患者护理的有用信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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