Sheffer HF, Bruce M, McLeod C, Richman J, Hardiman K, Chu D, Bhatia S, Hollis R. High risk populations for unplanned healthcare utilization following ostomy construction.
Am J Surg 2024:115799. [PMID:
38890038 DOI:
10.1016/j.amjsurg.2024.115799]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND
Patients with a new ostomy have high rates of unplanned healthcare utilization (UPHU). We used machine learning to assess which factors contributed the most to UPHU after ostomy construction.
METHODS
We retrospectively studied new ostomy patients between 2018 and 2021 at a single institution. The primary outcome was UPHU within 60 days of discharge. Factors that contributed the most to UPHU were assessed using a classification tree machine learning method.
RESULTS
Among 318 patients, 30.8 % of patients had an UPHU event. The classification tree identified diabetes mellitus as the most important factor associated with UPHU: 56 % of diabetics had UPHU. Smoking history was the next most important factor: 77 % of diabetics who smoked had UPHU. Patients who had diabetes, smoked, and had chronic kidney disease had the highest UPHU rate at 86 %.
DISCUSSION
Unplanned healthcare utilization after ostomy construction is highest among patients with diabetes, smoking history, and chronic kidney disease.
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