P2413 - Candidal Esophagitis: Thirty-Day Readmission Rate and Resource Utilization

Khadija Naseem, MD¹, Kamesh Gupta, MD², Abdullah Sohail, MD³, Adil Memon, MD¹, Adnan Malik, MD⁴, Ahmad Khan, MD¹, Shailendra Singh, MD^5
1West Virginia University, Charleston Division, Charleston, WV; ²Baystate Medical Center, Springfield, MA; ³West Virginia University Charleston Division, Charleston, WV; ⁴Loyola University Medical Center, Maywood, IL; ⁵West Virginia University Health Sciences Center, Morgantown, WV

Introduction: Candidal esophagitis is the most common cause of infectious esophagitis that may require hospitalization. Failure to respond to therapy sometimes leads to frequent rehospitalizations, which leads to an increase in the burden on healthcare utilization. We aimed to investigate the frequency of 30-day readmissions and associated outcomes for patients with candida esophagitis using a large readmission database analysis.

Methods: We queried the national readmission database (NRD) to identify all the patients hospitalized with candidal esophagitis using the ICD-10 CM code “B37.81”. We included all the patients' age ≥ 18 years old who had non-elective admissions between January 1st to November 30th, 2016. Our primary outcomes included determination of 30-day readmission rate and the most common principal discharge diagnosis leading to these admissions. Secondary outcomes included in-hospital mortality, length of stay (LOS), and total hospitalization charges between index and rehospitalizations. We also performed univariate and multivariate cox regression analyses to identify predictors of readmissions.

Results: We identified a total of 40,120 admissions for candidal esophagitis in the NRD 2016, and among them, 38,175 survived the index admission. Out of those, a total of 8,223 (21.52%) patients got readmitted within the next 30 days. The mean time to readmission was calculated as 12.67 days. The most common diagnosis associated with readmissions included sepsis, HIV, and acute kidney injury, respectively. Patients with readmissions were associated with higher inpatient mortality (7.13% vs. 4.80%) but mean LOS (7.13 days vs. 9.85 days) and mean hospitalization charges ($54,475.94 vs. $62,847.95) were decreased as compared to index admissions. Nevertheless, readmissions added a total of 60,014 days and $5.77 X 108 to the healthcare expenditure. Multivariate cox regression analysis identified Medicaid (adj HR 1.04, p-value < 0.001), high Charlson comorbidity index (adj HR 1.05, p-value < 0.001) and increased LOS (adj HR 1.004, p-value < 0.001) as independent predictors for readmission.

Discussion: Our study demonstrated that one out of five patients gets readmitted within the next 30 days with preventable conditions such as sepsis and acute kidney injury. Appropriate measures taken to minimize the risk of sepsis and AKI in these patients can help reduce the unnecessary financial burden associated with readmissions.


Figure: Patient characteristics and outcomes related to candidal esophagitis


Disclosures:
Khadija Naseem indicated no relevant financial relationships.
Kamesh Gupta indicated no relevant financial relationships.
Abdullah Sohail indicated no relevant financial relationships.
Adil Memon indicated no relevant financial relationships.
Adnan Malik indicated no relevant financial relationships.
Ahmad Khan indicated no relevant financial relationships.
Shailendra Singh indicated no relevant financial relationships.


Khadija Naseem, MD¹, Kamesh Gupta, MD², Abdullah Sohail, MD³, Adil Memon, MD¹, Adnan Malik, MD⁴, Ahmad Khan, MD¹, Shailendra Singh, MD⁵. P2413 - Candidal Esophagitis: Thirty-Day Readmission Rate and Resource Utilization, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.