Inpatient Endoscopy Procedure Planning Delays and Impact on Length of Stay and 30-day Readmission

Study Overview
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Brief Summary
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Single center retrospective cohort study of all inpatient endoscopy procedures to asses factors associated with inpatient endoscopy delays and impact on length of stay and 30-day readmission

Detailed Description
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Background: Delays in inpatient endoscopy planning negatively influence the quality and accessibility of care. This may result in higher healthcare costs, negative health outcomes, and unnecessary readmissions and use of hospital beds. Additionally, prolonged hospital stay is associated with poorer health outcomes and risk of nosocomial infections, amongst others. Objective: To asses factors associated with inpatient endoscopy delays and impact on length of stay and 30-day readmission Study design: Single center retrospective cohort study of all inpatient endoscopy procedures (gastroscopy, colonoscopy, ERCP, sigmoidoscopy) during 2016-2022. Data will be identified and extracted using CTCue. Only pseudonymized data will be used. Inpatient endoscopy delay will be defined as the number of days between the planned date versus the actual date. Multivariable logistic regression models will be performed to assess factors associated with inpatient endoscopy delay.

Official Title
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Inpatient Endoscopy Procedure Planning Delays and Impact on Length of Stay and 30-day Readmission

Conditions
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Inpatient Endoscopy Delay, Readmission, Prolonged Hospital Stay

Intervention / Treatment
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* Procedure: Inpatient gastrointestinal endoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (>18 years) Clinical admission in any hospital department of at least two days during 1 January 2016 and 1 December 2022 Endoscopic procedure during clinical admission, including gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), flexible sigmoidoscopy, colonoscopy Exclusion Criteria: Elective admission Procedure only for insertion of nasogastric or nasojejunal (feeding) tube without any other diagnostic or therapeutic aims

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Inpatient gastrointestinal endoscopy|all inpatient endoscopy procedures (gastroscopy, colonoscopy, ERCP, sigmoidoscopy) during 2016-2022.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of inpatient endoscopy delays (IED) | IED will be defined as the number of days between the planned date versus the actual date. | at endoscopic procedure | 
| Difference in type of endoscopic procedure between patients with and without IED | Type of endoscopic procedure: gastroscopy/colonoscopy/endoscopic retrograde cholangio-pancreaticography (ERCP) | at endoscopic procedure | 
| Difference in type of sedation between patients with and without IED | Type of sedation during endoscopic procedure: No sedation/conscious sedation/general anesthesia | at endoscopic procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Median length of hospital stay | length of hospital admission in days | through study cohort period from 1 january 2016 until 31 december 2022 | 
| rate of 30-day readmissions | percentage of readmissions within 30 days after initial discharge | up to 30 days | 
| Odds ratio of presence of inpatient endoscopy delays for risk of prolonged length of hospital stay and 30-day readmissions | multivariable logistic regression modelling to assess factors associated with both outcomes and the impact of inpatient endoscopy delay | from admission till 30 days after discharge | 
| Odds ratio of presence of inpatient endoscopy delays for risk of 30-day readmissions | multivariable logistic regression modelling to assess factors associated with both outcomes and the impact of inpatient endoscopy delay | from admission till 30 days after discharge |