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Hospitalization, surgery, and readmission rates of IBD in Canada: a population-based study
Charles N Bernstein1, Alice Nabalamba
1Department of Internal Medicine and University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada.
Insights
Hospitalization rates for Crohn's disease (CD) slightly decreased, yet remained double that of ulcerative colitis (UC) in Canada. Both CD and ulcerative colitis patients experienced significant annual readmission rates and frequent major surgeries.
Area of Science:
- Gastroenterology
- Public Health
- Epidemiology
Background:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC).
- Understanding IBD hospitalization and readmission trends is crucial for healthcare resource allocation in Canada.
Purpose of the Study:
- To determine Canadian hospitalization and readmission rates for Crohn's disease and ulcerative colitis.
- To analyze trends in length of stay and surgical interventions for IBD patients.
Main Methods:
- Utilized the Statistics Canada Person-Oriented Information Database (1994-2001).
- Extracted hospitalization data using ICD-9-CM codes 555 (CD) and 556 (UC).
- Assessed age-, gender-, and disease-specific rates of hospitalization, length of stay, readmission, and surgery.
Main Results:
- Age-adjusted CD hospitalization rates declined from 29.2 to 26.9/100,000, while UC rates remained stable (12.6-13.3/100,000).
- Annual readmission rates were approximately 20% for both CD and UC patients; over 7 years, 39.4% of CD and 33.7% of UC patients were readmitted.
- Average length of stay decreased for both CD and UC. Major surgery occurred in 48% of CD and 55% of UC hospitalizations.
Conclusions:
- CD hospitalization rates decreased slightly but remained twice those of UC.
- Significant proportions of IBD patients require annual readmission, highlighting the chronic nature of these conditions.
- Major surgery was more prevalent in UC hospitalizations compared to CD.
Background:
We aimed to define the rates of hospitalization and readmission for inflammatory bowel disease in Canada.
Methods:
The data source was Statistics Canada Person Oriented Information Database (1994-2001). The number of stays for a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) by ICD-9-CM code 555 or 556 was extracted (and assessed when CD or UC was the first diagnosis or was 1 of 16 diagnoses on the patient discharge abstract). Age-, gender-, and disease-specific rates of hospitalization, length of stay, readmission, and surgery were assessed.
Results:
The age-adjusted hospitalization rate for CD declined over 1994-2001 from 29.2 to 26.9/100,000 but was stable for UC at 12.6-13.3 per 100,000. In the 7 yr, 39.4% of CD patients (21.3-24.0%/yr) and 33.7% of UC patients (18.5-20.3%/yr) got readmitted at least once. The average length of stay declined from 10.3 (1994-1995) to 9.1 days (2000-2001) (p = 0.029) in CD and in UC declined from 12.2 to 10.1 days (p = 0.054). Of all hospitalizations, major surgery occurred in 48% of CD (44.8-49.8% per yr) and 55% of UC (51.5-59.0% per yr).
Conclusions:
Rates of hospitalization declined slightly for CD over the 7 yr but still remained twice as great as the rates for UC. Approximately 20% of CD and UC subjects got readmitted per year and over 7 yr approximately 35% got readmitted. Major surgery was a more common reason for hospitalization in UC than in CD.
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