covid -19相关住院后30天胃肠道再入院的独立预测因素和原因:对国家再入院数据库的分析

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Robert Kwei-Nsoro, Bashar Attar, Hafeez Shaka, Pius Ojemolon, Muhammad Sana, Abdul Tawab Shaka, Naveen Baskaran, Philip Kanemo, Mohankumar Doraiswamy
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引用次数: 2

摘要

背景:2019冠状病毒病(COVID-19)大流行在美国导致了显著的死亡率和发病率。COVID-19的负担不仅限于呼吸道,而且具有明显的肺外表现。我们决定研究指数COVID-19住院后30天再入院的胃肠道(GI)相关原因、预测因素和结果。方法:我们使用2020年以来的国家再入院数据库(NRD)来确定以COVID-19为主要诊断的成人住院情况。在排除选择性和创伤性住院后,我们确定了指数入院后30天内与gi相关的住院。我们确定了gi相关再入院的主要原因,以及这些住院治疗的结果。我们使用多变量Cox回归分析来确定再入院的独立预测因素。结果:在2020年NRD数据库中以初步诊断为COVID-19的1,024,492例指数住院患者中,有644,903例纳入了30天再入院研究。其中3,276例(0.5%)因原发性胃肠道原因在30天内再次入院。我们在这项研究中确定的再入院的前五大原因是胃肠道出血、肠梗阻、急性憩室炎、急性胰腺炎和急性胆囊炎。校正混杂因素的多因素Cox回归分析显示,肾功能衰竭、酒精滥用和消化性溃疡疾病与胃肠道相关原因导致的30天再入院几率增加相关。结论:COVID-19的胃肠道表现并不罕见,仍然是再入院的重要原因。针对确定的再入院可修改预测因素的有针对性的干预措施将有助于减轻本已有限的医疗资源的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Independent Predictors and Causes of Thirty-Day Gastrointestinal Readmissions Following COVID-19-Related Hospitalizations: Analysis of the National Readmission Database.

Independent Predictors and Causes of Thirty-Day Gastrointestinal Readmissions Following COVID-19-Related Hospitalizations: Analysis of the National Readmission Database.

Background: The coronavirus disease 2019 (COVID-19) pandemic led to significant mortality and morbidity in the United States. The burden of COVID-19 was not limited to the respiratory tract alone but had significant extrapulmonary manifestations. We decided to examine the causes, predictors, and outcomes of gastrointestinal (GI)-related causes of 30-day readmission following index COVID-19 hospitalization.

Methods: We used the National Readmission Database (NRD) from 2020 to identify hospitalizations among adults with principal diagnosis of COVID-19. We identified GI-related hospitalizations within 30 days of index admission after excluding elective and traumatic admissions. We identified the top causes of GI-related readmission, and the outcomes of these hospitalizations. We used a multivariate Cox regression analysis to identify the independent predictors of readmission.

Results: Among 1,024,492 index hospitalizations with a primary diagnosis of COVID-19 in the 2020 NRD database, 644,903 were included in the 30-day readmission study. Of these 3,276 (0.5%) were readmitted in 30 days due to primary GI causes. The top five causes of readmissions we identified in this study were GI bleeding, intestinal obstruction, acute diverticulitis, acute pancreatitis, and acute cholecystitis. Multivariate Cox regression analysis done adjusting for confounders showed that renal failure, alcohol abuse, and peptic ulcer disease were associated with increased odds of 30-day readmission from GI-related causes.

Conclusions: GI manifestations of COVID-19 are not uncommon and remain an important cause of readmission. Targeted interventions addressing the modifiable predictors of readmission identified will be beneficial in reducing the burden on already limited healthcare resources.

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Gastroenterology Research
Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-
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