Early and Late Readmissions of Radiation Proctitis in the United States: Are We Getting Better?

• Published in: Journal of clinical medicine Vol. 13; no. 2; p. 423
• Main Authors: Dahiya, Dushyant Singh, Pinnam, Bhanu Siva Mohan, Ishaya, Michelle, Chandan, Saurabh, Gangwani, Manesh Kumar, Singh, Sahib, Ali, Hassam, Sohail, Amir Humza, Canakis, Andrew, Ramai, Daryl, Zelt, Christina, Inamdar, Sumant, Al-Haddad, Mohammad, Rojas-DeLeon, Mariajose, Sharma, Neil R
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.01.2024
• Subjects: Age groups; Care and treatment; Comorbidity; Complications and side effects; cost; Economic aspects; Endoscopy; Health aspects; Health care reform; Hospital care; Hospitalization; Hospitals; Medical care, Cost of; Mortality; outcomes; Patients; Pelvic cancer; Proctitis; Radiation; radiation proctitis; Radiotherapy; readmission; Regression analysis; Risk factors; Sepsis; Statistics; Toxicity; India; United States > US; mortality; radiation proctitis; cost; outcomes; readmission
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13020423

Radiation proctitis (RP), a well-known complication of pelvic radiation therapy, may lead to recurrent hospitalizations. We aimed to assess readmissions of RP in the United States. We analyzed the Nationwide Readmission Database from 2016 to 2020 to identify all 30-, 60-, and 90-day readmissions of RP in the United States. Hospitalization characteristics, predictors, clinical outcomes, and healthcare burdens were assessed. From 2016 to 2020, we noted a declining trend of 30-, 60-, and 90-day readmissions of RP in the US. However, the all-cause 30-, 60-, and 90-day readmission rates of RP were still high at 13.7%, 19.4%, and 23.16%, respectively. On readmission, RP was identified as the admitting diagnosis in only 20.61%, 17.87%, and 15.76% of 30-, 60-, and 90-day readmissions, respectively. The mean age for all readmissions was 70 years with a significant male dominance. Lower endoscopy at index admission reduced the risk of readmissions within 90 days, but this was not statistically significant. However, the Charlson Comorbidity Index (CCI) score was an independent predictor of all readmissions. Furthermore, the mean length of stay was 5.57 (95% CI 5.15-6), 5.50 (95% CI 5.12-5.89), and 5.47 (95% CI 5.07-5.87) days and the mean hospitalization charge was USD 60,451 (95% CI USD 54,728-66,174), USD 62,671 (95% CI USD 57,326-68,015), and USD 62,144 (95% CI USD 57,144-67,144) for 30-, 60-, and 90-day readmissions. The all-cause inpatient mortality for 30-, 60-, and 90-day readmissions was 3.58%, 3.89%, and 3.46%, respectively. RP readmissions are a significant healthcare burden. Further efforts must be directed toward improving management strategies to reduce readmission rates.