{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T03:10:32Z","timestamp":1771211432518,"version":"3.50.1"},"reference-count":21,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Opioid use is common among patients hospitalized for inflammatory bowel disease (IBD) exacerbation and has been associated with an increased risk of readmissions. Prior studies, however, have mostly limited their analysis to hospital opioid use. This study examines opioid exposure and dosing before, during, and after hospitalization and its impact on 30- and 90-day hospital readmissions. Methods: We reviewed all adults admitted for an IBD exacerbation from 1 January 2016 to 3 January 2020, excluding pregnant patients and those with an IBD-related surgery. Use and dose of opioids before and during hospitalization and at discharge were identified through manual chart review. IBD type, demographics, and comorbidities were defined. The associations between opioid use characteristics and readmission were assessed using a series of multivariable logistic regression models. Results: Among 1062 patients meeting inclusion criteria, 191 (18.0%) were readmitted within 30 days of their index hospitalization, and 285 (26.8%) were readmitted within 90 days. Of these 1062 patients, 96 (9.02%) had preadmission opioid use, 340 (31.95%) had inpatient use, and 133 (12.50%) received a discharge opioid prescription. Preadmission, inpatient, and discharge opioid use were not associated with 30-day readmission. Preadmission and inpatient opioid use were also not associated with 90-day readmission; however, a prescription for an opioid at discharge was associated with 90-day readmission even after adjusting for confounders, OR 1.86 (1.27, 2.75), p = 0.002. On multivariable analysis, we also found that higher maximum daily dose of discharge opioids, OR 1.01 (1.00, 1.02), p = 0.037, was found to be associated with 30-day readmissions, and higher opioid doses preadmission, OR 1.01 (1.00, 1.03), p = 0.029, and at hospital discharge, OR 1.01 (1.00, 1.02), p = 0.034, were associated with increased 90-day readmission. Conclusions: Opioid prescribing at discharge poses a significant risk for readmissions. Discharge planning should emphasize minimal use of opioids at discharge.<\/jats:p>","DOI":"10.3390\/jcm14217658","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T03:44:39Z","timestamp":1761795879000},"page":"7658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of the Impact of Preadmission, Inpatient, and Discharge Opioid Exposure and Dose on 30- and 90-Day Hospital Readmissions in Patients with Inflammatory Bowel Disease Exacerbations"],"prefix":"10.3390","volume":"14","author":[{"given":"Ellen A.","family":"Oseni","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Northshore University Hospital, Manhasset, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Northshore University Hospital, Manhasset, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Izard","sequence":"additional","affiliation":[{"name":"Quantitative Intelligence, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Qiu","sequence":"additional","affiliation":[{"name":"Quantitative Intelligence, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjali","family":"Mone","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Lenox Hill Hospital, New York, NY 10075, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Swaminath","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Lenox Hill Hospital, New York, NY 10075, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7619-2024","authenticated-orcid":false,"given":"Keith","family":"Sultan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Northshore University Hospital, Manhasset, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/j.dld.2019.01.016","article-title":"Hospitalization Trends of the Inflammatory Bowel Disease Landscape: A nationwide overview of 16 years","volume":"51","author":"Dias","year":"2019","journal-title":"Dig. Liver Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ibd\/izz104","article-title":"The Cost of Inflammatory Bowel Disease: An Initiative From the Crohn\u2019s & Colitis Foundation","volume":"26","author":"Park","year":"2020","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.cgh.2020.08.041","article-title":"Opioid Use Among Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","volume":"19","author":"Niccum","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1093\/ibd\/izac021","article-title":"The Relationship Between Opioid Use and Healthcare Utilization in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","volume":"28","author":"Sheehan","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1093\/ibd\/izac218","article-title":"Opioid Legislation in Patients With Inflammatory Bowel Disease: A State-wide Retrospective Cohort Study","volume":"29","author":"Ahmed","year":"2023","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.cgh.2017.10.022","article-title":"Increasing Prescription of Opiates and Mortality in Patients With Inflammatory Bowel Diseases in England","volume":"16","author":"Burr","year":"2018","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1007\/s10620-019-05906-x","article-title":"Pain in Inflammatory Bowel Disease Is Not Improved During Hospitalization: The Impact of Opioids on Pain and Healthcare Utilization","volume":"65","author":"Berry","year":"2020","journal-title":"Dig. Dis. Sci."},{"key":"ref_8","first-page":"1030","article-title":"The Impact of Opioid Epidemic Trends on Hospitalized Inflammatory Bowel Disease Patients","volume":"12","author":"Rosenblatt","year":"2018","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/ecco-jcc\/jjz198","article-title":"Opioid Use Disorder Increases 30-Day Readmission Risk in Inflammatory Bowel Disease Hospitalizations: A Nationwide Matched Analysis","volume":"19","author":"Charilaou","year":"2020","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Micic, D., Gaetano, J.N., Rubin, J.N., Cohen, R.D., Sakuraba, A., Rubin, D.T., and Pekow, J. (2017). Factors Associated with Readmission to the Hospital within 30 days in Patients with Inflammatory Bowel Disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0182900"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.bja.2017.12.044","article-title":"Association Between Intraoperative Opioid Administration and 30-day readmission: A pre-specified analysis of registry data from a healthcare network in New England","volume":"120","author":"Long","year":"2018","journal-title":"Br. J. Anesth."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1097\/MIB.0000000000001213","article-title":"Predictors of Early Readmission in Hospitalized Patients with Inflammatory Bowel Disease","volume":"23","author":"Christian","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.cgh.2014.02.042","article-title":"Factors Associated with Readmissions and Outcomes of Patients Hospitalized for Inflammatory Bowel Disease","volume":"12","author":"Nguyen","year":"2014","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1097\/MIB.0000000000001242","article-title":"Inflammatory Bowel Disease: Predictors and Causes of Early and Late Hospital Readmissions","volume":"23","author":"Mudireddy","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_15","first-page":"5","article-title":"Risk Factors for 90 Day Readmissions in Veterans with Inflammatory Bowel Disease- Does Post-discharge Follow Up Matter?","volume":"5","author":"Malhotra","year":"2018","journal-title":"Mil. Med. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"99","DOI":"10.14740\/jocmr4846","article-title":"Cannabis Use and Its Association With Thirty- and Ninety-Day Hospital Readmissions for Patients Admitted for an Inflammatory Bowel Disease Exacerbation","volume":"15","author":"Oseni","year":"2023","journal-title":"J. Clin. Med. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.3109\/00365521.2015.1020862","article-title":"Early readmission in patients hospitalized for ulcerative colitis: Incidence and risk factors","volume":"50","author":"Tinsley","year":"2015","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/apt.70203","article-title":"Higher Prescribed Opioid Use Among Adults With Crohn\u2019s Disease Than General Population: A Nationwide Cohort Study in Sweden 2006-2021","volume":"62","author":"Osooli","year":"2025","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Zheng, M., DeDecker, L., Chen, P.H., and Limketkai, B.N. (J. Clin. Gastroenterol., 2025). Trends in Substance Use Disorder Among Hospitalized Patients With Inflammatory Bowel Disease: An 11-Year Nationwide Study, J. Clin. Gastroenterol., ahead of print.","DOI":"10.1097\/MCG.0000000000002205"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1038\/ajg.2012.343","article-title":"Hospital Readmissions in Patients with Inflammatory Bowel Disease","volume":"108","author":"Hazratjee","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.1016\/j.cgh.2019.12.024","article-title":"Exposure to Intravenous Opioids is Associated with Future Exposure to Opioids in Hospitalized Patients with Inflammatory Bowel Diseases","volume":"18","author":"Dalal","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7658\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T04:09:14Z","timestamp":1761797354000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,28]]},"references-count":21,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14217658"],"URL":"https:\/\/doi.org\/10.3390\/jcm14217658","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,28]]}}}