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Evaluating the Impact of Co-Existent Inflammatory Bowel Disease on Hospital-Based Outcomes Among Patients With Acute
Dheeraj Alexander1, Olga J Santiago-Rivera2, Laith H Jamil3,4
1Internal Medicine Residency Program, McLaren Flint Hospital, Flint, MI, USA.
Insights
Patients with ulcerative colitis (UC) hospitalized for acute pancreatitis (AP) face higher mortality risks. Crohn
Area of Science:
- Gastroenterology
- Internal Medicine
- Epidemiology
Background:
- Inflammatory bowel disease (IBD) is linked to a higher risk of pancreatitis.
- Investigating outcomes of acute pancreatitis (AP) in patients with co-existing Crohn's disease (CD) or ulcerative colitis (UC) is crucial.
Purpose of the Study:
- To evaluate the outcomes of acute pancreatitis (AP) in patients with co-existing inflammatory bowel disease (IBD), specifically Crohn's disease (CD) and ulcerative colitis (UC).
Main Methods:
- A cross-sectional study utilizing the 2020 National Inpatient Sample (NIS) database.
- Included patients aged over 18 with a primary diagnosis of AP.
- Analyzed in-hospital mortality, length of stay, hospital charges, and complications like hypovolemic shock, severe sepsis, acute kidney failure (AKI), and ICU admission.
Main Results:
- Among 32 million discharges, 258,965 had AP. Of these, 1,930 had CD and 1,170 had UC.
- Patients with UC and AP showed increased odds of in-hospital mortality (aOR: 3.62).
- Patients with CD and AP had increased odds of developing acute kidney failure (AKI) (aOR: 1.37).
Conclusions:
- Hospitalized patients with AP and co-existing UC face elevated in-hospital mortality risks.
- Hospitalized patients with AP and co-existing CD have increased odds of developing comorbid AKI.
- These findings highlight the distinct impacts of UC and CD on AP outcomes.
Background:
Inflammatory bowel disease (IBD) has been associated with increased risk of developing pancreatitis. We analyzed data from the National Inpatient Sample (NIS) with the aim of evaluating the outcomes of acute pancreatitis (AP) in patients with co-existent Crohn's disease (CD) or ulcerative colitis (UC).
Methods:
This was a cross-sectional study using the 2020 NIS database. Patients were included if they were more than 18 years old with a principal diagnosis of AP. Main outcome measurements of our study were in-hospital mortality, length of hospital stay, hospital total charges, incidences of hypovolemic shock, severe sepsis with and without shock, acute kidney failure (AKI), and the need for intensive care unit (ICU) care. Statistical analyses were performed on STATA version 18.0.
Results:
There were 258,965 (0.8%) admissions with the primary diagnosis of AP among the 32 million discharges in 2020 NIS database. Among patients with AP, a total of 1,930 (0.75%) and 1,170 (0.45%) hospitalizations had co-existing CD and UC, respectively. The overall in-hospital mortality for AP was 1,560 (0.62%). Patients with UC hospitalized for AP had increased odds of in-hospital mortality (adjusted odds ratio (aOR): 3.62, 95% confidence interval (CI): 1.310 - 9.978, P = 0.013) while for patients with CD, there were no in-hospital mortality. Patients with CD had increased odds of developing comorbid AKI (aOR: 1.37, 95% CI: 1.005 - 1.880, P = 0.047) when they present with AP but not those with UC.
Conclusions:
Patients hospitalized with AP had increased odds of in-hospital mortality and comorbid AKI when they have co-existent UC and CD, respectively.
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