Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 16, Number 3, June 2023, pages 157-164

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

Figure 1. Forrest plot of multivariate analysis of independent predictors associated with 30-day readmissions. CI: confidence interval.

**Table 1.** Baseline Characteristics of Patients Evaluated for Gastrointestinal Etiologies of 30-Day Readmissions Following Index COVID-19 Admission Stratified by Biological Sex
Characteristic	Males	Females	P value
COVID-19: coronavirus disease 2019; SD: standard deviation.
N = 3,276	54%	46%
Mean age ± SD (years)	66.4 ± 15.1	69.1 ± 16.1	< 0.001
Age category			0.005
18 - 44	9.2	8.8
45 - 64	33.6	26.2
≥ 65	57.2	65.0
Insurance type (%)			0.005
Medicaid	63.5	71.0
Medicare	16.5	11.0
Private	17.4	15.1
Uninsured	2.6	2.9
Elixhauser Comorbidity Index score (%)			0.066
0	2.8	2.4
1	6.2	3.7
2	11.6	9.5
3	15.9	15.6
4	63.5	68.8
Median household income (%)		0.311
< $49,999	34.8	37.7
≥ $50,000 to < $64,999	31.4	27.7
≥ $65,000 to < $85,999	19.1	20.7
≥ 86,000	14.7	13.9
Location/teaching status of the hospital (%)			0.791
Rural	17.4	18.8
Urban non-teaching	72.4	71.0
Urban teaching	10.2	10.2
Hospital bed size (%)			0.403
Small	17.3	19.4
Medium	24.3	25.6
Large	58.4	55.0

Table 1. Baseline Characteristics of Patients Evaluated for Gastrointestinal Etiologies of 30-Day Readmissions Following Index COVID-19 Admission Stratified by Biological Sex

Characteristic

Males

Females

P value

COVID-19: coronavirus disease 2019; SD: standard deviation.

N = 3,276

54%

46%

Mean age ± SD (years)

66.4 ± 15.1

69.1 ± 16.1

< 0.001

Age category

0.005

18 - 44

9.2

8.8

45 - 64

33.6

26.2

≥ 65

57.2

65.0

Insurance type (%)

0.005

Medicaid

63.5

71.0

Medicare

16.5

11.0

Private

17.4

15.1

Uninsured

2.6

2.9

Elixhauser Comorbidity Index score (%)

0.066

2.8

2.4

6.2

3.7

11.6

9.5

15.9

15.6

63.5

68.8

Median household income (%)

0.311

< $49,999

34.8

37.7

≥ $50,000 to < $64,999

31.4

27.7

≥ $65,000 to < $85,999

19.1

20.7

≥ 86,000

14.7

13.9

Location/teaching status of the hospital (%)

0.791

Rural

17.4

18.8

Urban non-teaching

72.4

71.0

Urban teaching

10.2

Hospital bed size (%)

0.403

Small

17.3

19.4

Medium

24.3

25.6

Large

58.4

55.0

**Table 2.** The Five Most Common Gastrointestinal Etiologies of 30-Day Readmissions Following Index COVID-19 Admission.
N= 3,276	Proportion (%)
COVID-19: coronavirus disease 2019.
Gastrointestinal hemorrhage	29.7
Intestinal obstruction	5.5
Diverticulitis	4.3
Acute pancreatitis	3.8
Acute cholecystitis	3.1

Table 2. The Five Most Common Gastrointestinal Etiologies of 30-Day Readmissions Following Index COVID-19 Admission.

N= 3,276

Proportion (%)

COVID-19: coronavirus disease 2019.

Gastrointestinal hemorrhage

29.7

Intestinal obstruction

5.5

Diverticulitis

4.3

Acute pancreatitis

3.8

Acute cholecystitis

3.1

**Table 3.** Mortality, Length of Stay, and Total Hospitalization Charges on Index Admission Compared With 30-Day Readmission.
Outcomes	Index admission	30-day readmission
SD: standard deviation.
Mortality (%)	11.6	5.1
Length of stay (days ± SD)	8.1 ± 0.1	6.4 ± 0.2
Total hospitalization charges ($)	20,135	16,738

Table 3. Mortality, Length of Stay, and Total Hospitalization Charges on Index Admission Compared With 30-Day Readmission.

Outcomes

Index admission

30-day readmission

SD: standard deviation.

Mortality (%)

11.6

5.1

Length of stay (days ± SD)

8.1 ± 0.1

6.4 ± 0.2

Total hospitalization charges ($)

20,135

16,738

**Table 4.** Mortality, Length of Stay, and Total Hospitalization Charges on 30-Day Readmission Stratified by Biological Sex
Outcomes	Male	Female	P value
SD: standard deviation.
Mortality (%)	4.94	5.35	0.700
Length of stay (days ± SD)	6.4 ± 0.3	6.5 ± 0.1	0.952
Total hospitalization charges ($)	16,770	16,700	0.962

Table 4. Mortality, Length of Stay, and Total Hospitalization Charges on 30-Day Readmission Stratified by Biological Sex

Outcomes

Male

Female

P value

SD: standard deviation.

Mortality (%)

4.94

5.35

0.700

Length of stay (days ± SD)

6.4 ± 0.3

6.5 ± 0.1

0.952

Total hospitalization charges ($)

16,770

16,700

0.962

**Table 5.** Independent Predictors of 30-Day GI-Related Readmission Following Index COVID-19 Hospitalization
Variable	Hazard ratio (adjusted)	P value	Confidence interval
COVID-19: coronavirus disease 2019; SD: standard deviation; GI: gastrointestinal.
Female	0.96	0.521	0.87 - 1.07
Age 44 - 65	1.11	0.281	0.92 - 1.35
Age > 65	1.11	0.381	0.88 - 1.40
Medicare	1.02	0.816	0.85 - 1.23
Private insurance	0.59	0.000	0.49 - 0.72
Uninsured	0.62	0.027	0.41 - 0.95
Congestive heart failure	1.39	0.000	1.18 - 1.63
Cardiac arrhythmias	1.06	0.311	0.95 - 1.19
Valvular heart disease	0.91	0.415	0.72 - 1.15
Pulmonary circulation disorders	1.17	0.116	0.96 - 1.45
Peripheral vascular disorders	1.19	0.069	0.99 - 1.44
Hypertension, uncomplicated	1.05	0.432	0.93 - 1.20
Paralysis	1.13	0.082	0.98 - 1.29
Other neurological disorders	1.08	0.216	0.96 - 1.22
Chronic pulmonary disease	0.89	0.181	0.76 - 1.05
Diabetes, uncomplicated	0.99	0.879	0.87 - 1.13
Diabetes, complicated	1.14	0.061	0.99 - 1.30
Hypothyroidism	1.65	0.000	1.39 - 1.95
Renal failure	3.06	0.000	2.63 - 3.56
Peptic ulcer disease	1.92	0.021	1.10 - 3.35
Lymphoma	1.24	0.415	0.74 - 2.09
Metastatic cancer	1.26	0.393	0.74 - 2.12
Solid tumor without metastasis	1.57	0.008	1.13 - 2.19
Coagulopathy	1.47	0.000	1.29 - 1.68
Obesity	0.86	0.025	0.76 - 0.98
Weight loss	1.17	0.096	0.97 - 1.40
Fluid and electrolyte disorders	1.22	0.000	1.09 - 1.36
Blood loss anemia	1.64	0.109	0.89 - 3.00
Deficiency anemia	1.29	0.021	1.04 - 1.61
Alcohol abuse	2.67	0.000	2.17 - 3.29
Drug abuse	1.26	0.119	0.94 - 1.71
Depression	1.04	0.626	0.89 - 1.21
Hypertension, complicated	1.14	0.170	0.94 - 1.39

Table 5. Independent Predictors of 30-Day GI-Related Readmission Following Index COVID-19 Hospitalization

Variable

Hazard ratio (adjusted)

P value

Confidence interval

COVID-19: coronavirus disease 2019; SD: standard deviation; GI: gastrointestinal.

Female

0.96

0.521

0.87 - 1.07

Age 44 - 65

1.11

0.281

0.92 - 1.35

Age > 65

1.11

0.381

0.88 - 1.40

Medicare

1.02

0.816

0.85 - 1.23

Private insurance

0.59

0.000

0.49 - 0.72

Uninsured

0.62

0.027

0.41 - 0.95

Congestive heart failure

1.39

0.000

1.18 - 1.63

Cardiac arrhythmias

1.06

0.311

0.95 - 1.19

Valvular heart disease

0.91

0.415

0.72 - 1.15

Pulmonary circulation disorders

1.17

0.116

0.96 - 1.45

Peripheral vascular disorders

1.19

0.069

0.99 - 1.44

Hypertension, uncomplicated

1.05

0.432

0.93 - 1.20

Paralysis

1.13

0.082

0.98 - 1.29

Other neurological disorders

1.08

0.216

0.96 - 1.22

Chronic pulmonary disease

0.89

0.181

0.76 - 1.05

Diabetes, uncomplicated

0.99

0.879

0.87 - 1.13

Diabetes, complicated

1.14

0.061

0.99 - 1.30

Hypothyroidism

1.65

0.000

1.39 - 1.95

Renal failure

3.06

0.000

2.63 - 3.56

Peptic ulcer disease

1.92

0.021

1.10 - 3.35

Lymphoma

1.24

0.415

0.74 - 2.09

Metastatic cancer

1.26

0.393

0.74 - 2.12

Solid tumor without metastasis

1.57

0.008

1.13 - 2.19

Coagulopathy

1.47

0.000

1.29 - 1.68

Obesity

0.86

0.025

0.76 - 0.98

Weight loss

1.17

0.096

0.97 - 1.40

Fluid and electrolyte disorders

1.22

0.000

1.09 - 1.36

Blood loss anemia

1.64

0.109

0.89 - 3.00

Deficiency anemia

1.29

0.021

1.04 - 1.61

Alcohol abuse

2.67

0.000

2.17 - 3.29

Drug abuse

1.26

0.119

0.94 - 1.71

Depression

1.04

0.626

0.89 - 1.21

Hypertension, complicated

1.14

0.170

0.94 - 1.39