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Hospitalizations for Crohn's Disease - United States, 2003-2013
Insights
Hospitalizations for Crohn's disease remained stable between 2003 and 2013, despite new treatments. Patient education on triggers and medication adherence is crucial for preventing future Crohn's disease hospitalizations.
Area of Science:
- Gastroenterology
- Public Health
- Health Services Research
Background:
- Crohn's disease is a significant inflammatory bowel disorder affecting the gastrointestinal tract.
- It can cause severe symptoms requiring hospitalization and surgery.
- In 2009, an estimated 565,000 Americans were diagnosed with Crohn's disease.
Purpose of the Study:
- To analyze trends in U.S. hospitalizations for Crohn's disease from 2003 to 2013.
- To examine surgical procedures performed during these hospitalizations.
- To assess the impact of new therapies on hospitalization rates.
Main Methods:
- Utilized National Inpatient Sample (NIS) data from the Healthcare Cost and Utilization Project (HCUP).
- Estimated hospitalizations for Crohn's disease as both first-listed and any-listed diagnoses.
- Analyzed rates of common surgical procedures during hospitalizations.
Main Results:
- First-listed Crohn's disease hospitalizations showed no significant change from 2003 to 2013.
- Small bowel resection rates decreased, while colorectal resection and fistula repair rates remained stable.
- Hospital stays for any-listed Crohn's disease increased by over 50% during the study period.
Conclusions:
- Despite advancements in therapies, hospitalizations for Crohn's disease did not significantly decrease.
- Increased patient education on exacerbating factors and medication compliance is recommended to reduce hospitalizations.
- Further research into effective management strategies is warranted.
Abstract:
In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization and surgeries of the small intestine, colon, or rectum (2). Hospital discharge data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) were used to estimate U.S. hospitalizations† for Crohn's disease as both the first-listed and any-listed§ discharge diagnosis and common surgical procedures during hospitalizations with Crohn's disease as first-listed diagnosis from 2003 to 2013, the most recent decade of data. Despite new therapies that were expected to improve remission and reduce hospitalizations, estimated numbers (and age-adjusted rates per 100,000 U.S. population) of hospitalizations for Crohn's disease as the first-listed diagnosis did not change significantly from 2003 to 2013. The proportion of these hospitalizations during which small bowel resection was performed decreased from 4.9% in 2003 to 3.9% in 2013 (p<0.05); however, colorectal resection and fistula repair rates remained stable. Hospital stays for any-listed Crohn's disease increased from >120,000 (44.2 per 100,000) in 2003 to >196,000 (59.7 per 100,000) in 2013 (p<0.05). Patient education initiatives should focus on increasing awareness of exacerbating factors and medication compliance to prevent hospitalizations.