Faculty Collaboration Database

A nationwide analysis of changes in severity and outcomes of inflammatory bowel disease hospitalizations. J Gastrointest Surg 2011 Feb;15(2):267-76

Date

11/26/2010

Pubmed ID

21108015

DOI

10.1007/s11605-010-1396-3

Scopus ID

2-s2.0-79751531102 (requires institutional sign-in at Scopus site)   61 Citations

Abstract

INTRODUCTION: The past decade has seen a change in inflammatory bowel disease (IBD; Crohn's disease (CD) and ulcerative colitis (UC)) treatment, with increasing use of immunomodulators and biologics. The impact of this on IBD hospitalization outcomes is unknown.

METHODS: We identified hospitalizations with a diagnosis of IBD using data from the Nationwide Inpatient Sample, a national US discharge database. We compared the proportion of hospitalizations resulting in surgery in the entire cohort and within each disease severity stratum for the years 1998, 2004, and 2007.

RESULTS: There were an estimated 89,673 hospitalizations for CD in 1998 increasing to 150,593 hospitalizations in 2007. UC hospitalizations increased from 56,911 in 1998 to 86,611 in 2007. This increase was primarily among low or intermediate severity hospitalizations not requiring surgery. For CD, the proportion of bowel surgeries during hospitalization decreased from 17.3% in 1998 to 12.4% in 2007 (p < 0.001) while for UC, the proportion of colectomy decreased from 9.5% in 1998 to 6.2% in 2007 (p < 0.001). For both diagnoses, this reduction was significant in those with a low severity of disease but not with in those with the highest severity stratum.

CONCLUSIONS: There continues to be an increase in the number of hospitalizations in patients with IBD. The numbers of non-elective bowel surgeries among those with the highest severity of disease continues to increase suggesting need for further research into improving outcomes in this cohort at high risk for adverse outcome.

Author List

Ananthakrishnan AN, McGinley EL, Binion DG, Saeian K

Author

Kia Saeian MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Colectomy
Colitis, Ulcerative
Crohn Disease
Databases, Factual
Elective Surgical Procedures
Female
Hospitalization
Humans
Length of Stay
Logistic Models
Male
Middle Aged
Multivariate Analysis
Severity of Illness Index
United States