PDF(Pubmed)
Abstract：
UNASSIGNED: Gastrointestinal (GI) disorders represent a significant burden on United States healthcare, but research assessing the relative contribution of individual GI disorders is lacking. We aimed to determine the relative impact of various GI conditions, as compared to non-GI conditions, on US hospital-related healthcare utilization.
UNASSIGNED: Hospitalization data from 2016 to 2018 were obtained from the Nationwide Readmissions Database. Outcomes included length of stay, hospital charges, 30-day readmissions, and death. Multivariable regression models evaluated each outcome, while adjusting for patient and hospital characteristics. Patients hospitalized for each GI indication were compared to individuals hospitalized for non-GI conditions.
UNASSIGNED: 5,344,145 patients with GI and 68,901,595 patients with non-GI indications for hospitalization were included in our study. All GI indications were associated with increased odds for 30-day readmission compared to non-GI indications, with the highest being gastroparesis (adjusted odds ratio, 2.15; 95% confidence interval [CI], 2.09-2.22). Upper GI cancer had the highest relative increase in length of stay (2.31 days, 95% CI 2.20-2.42) and total charges ($23,441, 95% CI $21,296-25,587). Upper GI cancer, pancreatic cancer, and gallbladder/biliary cancer were associated with the highest odds of death.
UNASSIGNED: GI malignancies contributed significantly to utilization and death, possibly from advanced stage at hospitalization and systemic effects of malignancy. The high GI-specific readmission rates highlight the chronicity of GI conditions and the importance of optimizing digestive health to prevent recurrent admission.
UNASSIGNED: Hospitalization data from 2016 to 2018 were obtained from the Nationwide Readmissions Database. Outcomes included length of stay, hospital charges, 30-day readmissions, and death. Multivariable regression models evaluated each outcome, while adjusting for patient and hospital characteristics. Patients hospitalized for each GI indication were compared to individuals hospitalized for non-GI conditions.
UNASSIGNED: 5,344,145 patients with GI and 68,901,595 patients with non-GI indications for hospitalization were included in our study. All GI indications were associated with increased odds for 30-day readmission compared to non-GI indications, with the highest being gastroparesis (adjusted odds ratio, 2.15; 95% confidence interval [CI], 2.09-2.22). Upper GI cancer had the highest relative increase in length of stay (2.31 days, 95% CI 2.20-2.42) and total charges ($23,441, 95% CI $21,296-25,587). Upper GI cancer, pancreatic cancer, and gallbladder/biliary cancer were associated with the highest odds of death.
UNASSIGNED: GI malignancies contributed significantly to utilization and death, possibly from advanced stage at hospitalization and systemic effects of malignancy. The high GI-specific readmission rates highlight the chronicity of GI conditions and the importance of optimizing digestive health to prevent recurrent admission.
摘要：
■胃肠道（GI）疾病对美国医疗保健构成了重大负担，但是缺乏评估个体胃肠道疾病的相对贡献的研究。我们的目的是确定各种胃肠道条件的相对影响，与非GI条件相比，关于美国医院相关医疗保健的利用。
■2016年至2018年的住院数据来自全国再入院数据库。结果包括逗留时间，医院收费,再入院30天,和死亡。多变量回归模型评估了每个结果，同时调整患者和医院的特点。将因每个GI适应症住院的患者与因非GI病症住院的个体进行比较。
■5,344,145例GI患者和68,901,595例非GI适应症住院患者纳入本研究。与非GI指征相比，所有GI指征与30天再入院的几率增加相关。最高的是胃轻瘫(调整后的赔率比，2.15；95%置信区间[CI]，2.09-2.22)。上消化道癌的住院时间相对增加最高（2.31天，95%CI2.20-2.42）和总费用（23,441美元，95%CI21,296-25,587美元）。上消化道癌,胰腺癌,和胆囊/胆道癌与最高的死亡几率相关。
■胃肠道恶性肿瘤对利用和死亡有显著贡献，可能来自住院晚期和恶性肿瘤的全身影响。高的胃肠道特异性再入院率突出了胃肠道疾病的慢性性以及优化消化系统健康以防止反复入院的重要性。
■2016年至2018年的住院数据来自全国再入院数据库。结果包括逗留时间，医院收费,再入院30天,和死亡。多变量回归模型评估了每个结果，同时调整患者和医院的特点。将因每个GI适应症住院的患者与因非GI病症住院的个体进行比较。
■5,344,145例GI患者和68,901,595例非GI适应症住院患者纳入本研究。与非GI指征相比，所有GI指征与30天再入院的几率增加相关。最高的是胃轻瘫(调整后的赔率比，2.15；95%置信区间[CI]，2.09-2.22)。上消化道癌的住院时间相对增加最高（2.31天，95%CI2.20-2.42）和总费用（23,441美元，95%CI21,296-25,587美元）。上消化道癌,胰腺癌,和胆囊/胆道癌与最高的死亡几率相关。
■胃肠道恶性肿瘤对利用和死亡有显著贡献，可能来自住院晚期和恶性肿瘤的全身影响。高的胃肠道特异性再入院率突出了胃肠道疾病的慢性性以及优化消化系统健康以防止反复入院的重要性。
