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Depression Predicts Prolonged Length of Hospital Stay in Pediatric Inflammatory Bowel Disease
Perseus V Patel1, Matthew S Pantell, Melvin B Heyman
1Department of Pediatrics, University of California San Francisco Benioff Children's Hospital San Francisco, CA.
Insights
Depression significantly prolongs hospital stays for pediatric inflammatory bowel disease (IBD) patients. Early screening and intervention for depression may improve inpatient outcomes for these children.
Area of Science:
- Pediatric Gastroenterology
- Child Psychiatry
- Health Services Research
Background:
- Inflammatory Bowel Disease (IBD) affects children and adolescents.
- The impact of depression on IBD-related hospitalizations is understudied.
- Depression may influence healthcare utilization and outcomes in pediatric IBD.
Purpose of the Study:
- To evaluate the association between depression and hospital length of stay (LOS) in pediatric IBD patients.
- To determine if depression increases the risk of additional imaging and procedures during hospitalization.
- To investigate the relationship between depression and IBD-related inpatient resource utilization.
Main Methods:
- Utilized the 2012 Kids Inpatient Database (KID) for a nationally representative sample.
- Included hospitalizations for pediatric patients (<21 years) with Crohn disease or ulcerative colitis.
- Employed multivariable logistic regression to analyze the association between depression and prolonged LOS, controlling for confounders.
Main Results:
- Depression was significantly associated with prolonged LOS (OR 1.50) in pediatric IBD hospitalizations.
- Depression was also linked to increased total parenteral nutrition use (OR 1.54).
- No significant association was found between depression and increased likelihood of surgery, endoscopy, blood transfusion, or abdominal imaging.
Conclusions:
- Depression is a significant factor contributing to prolonged hospital stays in pediatric IBD patients.
- These findings hold true even when accounting for gastrointestinal disease severity.
- Standardized depression screening and early intervention strategies are recommended to improve inpatient outcomes.
Objective:
Few studies report the impact of depression on inflammatory bowel disease (IBD)-related hospitalizations. We evaluated the association between depression and pediatric IBD-related hospitalizations. Our primary aim was to test the hypothesis that depression is associated with hospital length of stay (LOS); our secondary goal was to evaluate if patients with depression are at higher risk for undergoing additional imaging and procedures.
Methods:
Data were extracted from the 2012 Kids Inpatient Database (KID), the largest nationally representative publicly available all-payer pediatric inpatient cross-sectional database in the United States. Hospitalizations for patients less than 21 years with a primary diagnosis Crohn disease (CD) or ulcerative colitis (UC) by ICD-9 code were included. Multivariable logistic regression was used to predict long LOS controlling for patient- and hospital-level variables and for potential disease confounders.
Results:
For primary IBD-related hospitalizations (N = 8222), depression was associated with prolonged LOS (odds ratio [OR] 1.50; 95% confidence interval [CI] 1.19-1.90) and total parenteral nutrition use (OR 1.54; 95% CI 1.04-2.27). Depression was not associated with increased likelihood of surgery (OR 0.97; 95% CI 0.72-1.30), endoscopy (OR 0.91; 95% CI 0.74-1.14), blood transfusion (OR 0.85; 95% CI 0.58-1.23), or abdominal imaging (OR 1.15; 95% CI 0.53-2.53).
Conclusions:
Depression is associated with prolonged LOS in pediatric patients with IBD, even when controlling for gastrointestinal disease severity. Future research evaluating the efficacy of standardized depression screening and early intervention may be beneficial to improving inpatient outcomes in this population.
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