Faculty Collaboration Database

Does it matter where you are hospitalized for inflammatory bowel disease? A nationwide analysis of hospital volume. Am J Gastroenterol 2008 Nov;103(11):2789-98

Date

08/08/2008

Pubmed ID

18684184

DOI

10.1111/j.1572-0241.2008.02054.x

Scopus ID

2-s2.0-55349126387 (requires institutional sign-in at Scopus site)   106 Citations

Abstract

OBJECTIVE: To examine if a high hospital volume was associated with superior outcomes in inflammatory bowel disease (IBD) patients requiring hospitalization.

METHODS: This was a cross-sectional study using data from the Nationwide Inpatient Sample (NIS 2004). IBD-related hospitalizations were identified using appropriate International Classification of Diseases, Ninth revision, Clinical modification (ICD-9-CM) codes. Hospital volume was divided into low, medium, and high by assigning the threshold cutoff values of 1-50, 51-150, and >150 annual IBD hospitalizations, respectively. Our primary outcomes were in-hospital mortality, length of stay, and postoperative complications and stay.

RESULTS: Patients at high-volume centers were more likely to be hospitalized with fistulizing or stricturing disease. The adjusted mortality was lower for IBD-related discharges from high-volume centers for those undergoing abdominal surgery (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.18-0.78), but not among those who did not undergo surgery (OR 0.90, 95% CI 0.53-1.52). Patients at high-volume centers were also more likely to undergo surgery (OR 2.24, 95% CI 1.40-3.58). These differences were more prominent in Crohn's disease than in ulcerative colitis.

CONCLUSION: Hospitals with a high annual IBD volume have lower in-hospital mortality among surgical IBD patients. This suggests a need for future research into identifying the quality-of-care measures in IBD and instituting appropriate interventions to improve overall IBD outcomes.

Author List

Ananthakrishnan AN, McGinley EL, Binion DG

Author

Emily L. McGinley Biostatistician III in the Center for Advancing Population Science department at Medical College of Wisconsin

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

Adult
Aged
Cross-Sectional Studies
Female
Hospital Mortality
Hospitalization
Hospitals
Humans
Inflammatory Bowel Diseases
Length of Stay
Male
Middle Aged
Postoperative Complications
Treatment Outcome
United States