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Hospital-Acquired Conditions Are Associated with Worse Outcomes in Crohn’s Disease-Related Hospitalizations

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Abstract

Background

Crohn’s disease (CD) is a chronically relapsing condition that frequently requires hospitalization. In 2008, the Centers for Medicare and Medicaid Services selected ten conditions that were deemed healthcare-acquired conditions (HACs). Costs related to HACs are not reimbursed as they are considered to be preventable.

Aim

To determine the prevalence and impact of HACs on hospital outcomes of hospitalized CD patients.

Methods

This was a cross-sectional study using data from the Nationwide Inpatient Sample between 2007 and 2011 with an extended time frame between 2002 and 2013 to specifically evaluate the prevalence of HACs. CD-related hospitalizations and HACs were identified using International Classification of Diseases, Ninth revision, Clinical modification codes. The trend of HACs between 2002 and 2013 was assessed using a Cochran–Armitage test. Primary outcomes, including hospital mortality, length of stay, and hospital charges, were analyzed using univariate and multivariate analyses.

Results

The prevalence of HACs initially increased between 2002 and 2008, remained stable between 2008 and 2011, than significantly decreased from 2011 to 2013. CD patients with HACs had higher hospital mortality, prolonged LOS, and higher hospital charges compared to patients without HACs.

Conclusions

The prevalence of HACs among hospitalized CD patients initially increased from 2002 to 2008; however, rates began to decrease between 2011 and 2013. In addition, HACs were associated with worse healthcare outcomes in hospitalized CD patients.

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA

    Kenneth Obi, Edward Levine, Darwin Conwell & Cheng Zhang

  2. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA

    Alice Hinton

  3. Department of Medicine, The Ohio State University, Wexner Medical Center, Columbus, OH, USA

    Lindsay Sobotka

Authors
  1. Kenneth Obi
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  2. Alice Hinton
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  3. Lindsay Sobotka
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  4. Edward Levine
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  5. Darwin Conwell
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  6. Cheng Zhang
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Contributions

KO developed the concept and drafted the manuscript. AH performed the statistical analysis. LS edited the manuscript. EL, DC, and CZ developed the concept and edited the manuscript.

Corresponding author

Correspondence to Cheng Zhang.

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Electronic supplementary material

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Supplementary material 1 (DOCX 151 kb)

Appendices

Appendix 1

See Table 3.

Table 3 The ICD-9-CM codes
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Appendix 2

See Table 4.

Table 4 Risk score to predict severe hospitalization course among patients with Crohn’s disease (CD)
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Obi, K., Hinton, A., Sobotka, L. et al. Hospital-Acquired Conditions Are Associated with Worse Outcomes in Crohn’s Disease-Related Hospitalizations. Dig Dis Sci 62, 1621–1627 (2017). https://doi.org/10.1007/s10620-017-4573-3

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  • DOI: https://doi.org/10.1007/s10620-017-4573-3

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