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

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

Study Overview

• Status: Not yet recruiting
• Conditions: Readmission; Inpatient Endoscopy Delay; Prolonged Hospital Stay
• Intervention / Treatment: Procedure: Inpatient gastrointestinal endoscopy

Detailed Description

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.

• Study Type: Observational
• Enrollment (Anticipated): 3700

Contacts and Locations

• Study Contact: Name: Milou van Riswijk, MD, Msc; Phone Number: +31615280185; Email: milou.vanriswijk@radboudumc.nl

Study Locations

• Netherlands
  • Gelderland
    • Nijmegen, Gelderland, Netherlands, 6525GA
      • Radboud University Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Adult inpatients from all hospital departments undergoing endoscopy procedures. Patients will be selected via CTCue, with an admission based query that selects all adult patients with an admission of at least two days between 1-1-2014 and 1-12-2022 AND an endoscopic care activity.

Description

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

Study Plan

How is the study designed?

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Radboud University Medical Center
• Investigators: Principal Investigator: Peter Siersema, MD, PhD, Radboud University Medical Center

Study record dates

Study Major Dates

• Study Start (Anticipated): April 1, 2023
• Primary Completion (Anticipated): June 30, 2023
• Study Completion (Anticipated): June 30, 2023

Study Registration Dates

• First Submitted: January 8, 2023
• First Submitted That Met QC Criteria: April 3, 2023
• First Posted (Actual): April 4, 2023

Study Record Updates

• Last Update Posted (Actual): April 4, 2023
• Last Update Submitted That Met QC Criteria: April 3, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: 2023-16151

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: IPD will be shared upon reasonable request
• IPD Sharing Time Frame: 15 years after publication date
• IPD Sharing Access Criteria: supporting information will be shared upon reasonable request
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No