P5364 - Incidence and Predictors of Hospital Readmission for Ulcerative Colitis

Abhik Roy, MD¹, Jennifer Chan, MD², Belia O.. Roybal, BA³, Fernando Velayos, MD⁴
1Kaiser Permanente, Oakland, CA; 2Kaiser Permanente, Redwood City, CA; 3Kaiser Permanente Northern California Division of Research, Pleasanton, CA; 4Kaiser Permanente, San Francisco, CA

Introduction: Over 3 million individuals in the U.S. live with inflammatory bowel disease, with approximately half affected by ulcerative colitis (UC). About 50% of UC patients require at least one disease-related hospitalization, and up to 20% may be readmitted within 30 days. Existing U.S.-based studies are limited by small sample sizes, poor generalizability, and lack of granular data on index hospitalizations and follow-up care.

Methods: We conducted a retrospective cohort study of adults hospitalized with a primary diagnosis of UC between January 2010 and September 2023 within a large integrated healthcare system serving over 4.5 million individuals. We evaluated the incidence of all-cause 30-day readmissions and identified predictors by analyzing patient characteristics, hospitalization details, post-discharge care, and maintenance UC therapy changes.

Results: The cohort included 942 patients (mean age 46.2 years; 50.5% female; 57% White). Of these, 151 patients (16%) were readmitted within 30 days. Univariate analysis showed readmitted patients had lower albumin levels at index admission (2.7 vs. 2.9 g/dL, p< 0.05) and longer length of stay (6.8 vs. 5.5 days, p< 0.05). Post-discharge, readmitted patients were less likely to follow up within 30 days with gastroenterology (26% vs. 70%, p< 0.001) or a primary care provider (39% vs. 77%, p< 0.001). They were also less likely to have a major change in UC therapy, defined as initiation of a new treatment (10% vs. 32%). Multivariate analysis, adjusted for demographics, comorbidities, medications, and follow-up, found that malnutrition (OR 1.9, 95% CI 1.2–3.2, p=0.01), lack of GI follow-up (OR 5.3, 95% CI 3.4–8.3, p< 0.01), and lack of PCP follow-up (OR 4.2, 95% CI 2.8–6.5, p< 0.01) were significantly associated with 30-day readmission. A major change in UC therapy was protective (OR 3.1, 95% CI 1.6–6.1, p=0.001).

Discussion: Patients hospitalized for UC face high 30-day readmission rates. While clinical factors such as malnutrition and longer index hospitalization are predictive, timely post-discharge interventions—including GI and PCP follow-up and UC treatment modification—may significantly reduce readmissions.

Disclosures:
Abhik Roy indicated no relevant financial relationships.
Jennifer Chan indicated no relevant financial relationships.
Belia Roybal indicated no relevant financial relationships.
Fernando Velayos indicated no relevant financial relationships.

Abhik Roy, MD¹, Jennifer Chan, MD², Belia O.. Roybal, BA³, Fernando Velayos, MD⁴. P5364 - Incidence and Predictors of Hospital Readmission for Ulcerative Colitis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.