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Factors associated with comorbidity in hospitalized and non-hospitalized inflammatory bowel disease patients: A
Marco Vincenzo Lenti1,2, Alice Silvia Brera2, Giacomo Broglio1,2
1Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.
Insights
Comorbidity is common in inflammatory bowel disease (IBD), affecting over 60% of patients. Factors like older age, female sex, and lower socioeconomic status are linked to higher comorbidity rates in IBD.
Area of Science:
- Gastroenterology
- Internal Medicine
- Public Health
Background:
- Inflammatory bowel disease (IBD) is frequently associated with comorbid conditions.
- Understanding the prevalence and factors influencing comorbidity in IBD is crucial for patient management.
Purpose of the Study:
- To assess the prevalence of comorbidity in hospitalized versus non-hospitalized patients with inflammatory bowel disease (IBD).
- To identify clinical and socioeconomic factors associated with comorbidity in IBD patients.
Main Methods:
- A comparative study of hospitalized IBD patients versus gender- and age-matched IBD outpatients (2:1 ratio) from the San MAtteo Complexity (SMAC) study (2017-2019).
- Assessment of comorbidity prevalence and its association with clinical and socioeconomic factors, including age, sex, frailty, income, education, and polypharmacy.
Main Results:
- Comorbidity was present in 60.6% of 104 IBD patients, with a slightly higher rate in hospitalized (66.6%) versus non-hospitalized (58.5%) individuals.
- Comorbid patients were older, had higher disease severity (CIRS score), were more often female, frailer, and had lower educational levels.
- Bivariable analysis identified age >65, female sex, income <1000€, schooling <8 years, frailty, and polypharmacy as factors associated with comorbidity.
Conclusions:
- A high prevalence of comorbidity exists in inflammatory bowel disease (IBD) patients.
- Low socioeconomic status and poor educational level may be significant contributing factors to the burden of comorbidity in IBD.
Background:
Inflammatory bowel disease (IBD) may be burdened by other comorbid conditions. We herein sought to assess comorbidity in hospitalized and non-hospitalized IBD patients.
Methods:
This was part of the San MAtteo Complexity (SMAC) study (2017-2019). Data of hospitalized IBD patients were compared to gender- and age-matched IBD outpatients in a 2:1 fashion. The association of comorbidity in relation to hospitalization and clinical and socioeconomic factors was assessed.
Results:
We included 104 patients, 27 hospitalized (median age 49 years, IQR 32-70) and 77 outpatients (median age 54 years, IQR 37-68). Comorbidity was reported in 63/104 patients (60.6%), of whom 45 (58.5%) non-hospitalized and 18 (66.6%) hospitalized. Patients with comorbidity were older (median 60 years, IQR 44-61 vs median 40 years, IQR 28-50 vs; p<0.001), had a higher Cumulative Illness Rating Scale severity index (median 1.85, IQR 1.5-2.5 vs median 1.31, IQR 1.2-2.5; p=0.002), were more commonly female (37, 60.7% vs 14, 35.0%; p=0.01), frailer (14, 22.2% vs 1, 2.4%; p=0.004), and had a lower educational level (13, 20.6% vs 2, 4.9%; p=0.04). In a bivariable analysis, factors associated to comorbidity were age >65 years (OR 5.30, 95% CI 1.81-15.55; p=0.002), female sex (OR 2.92, 95% CI 1-27-6.71; p=0.012), income <1000€ (OR 3.04, 95% CI 1.09-8.44; p=0.033), schooling <8 years (OR 5.09, 95% CI 1.08-23.96; p=0.039), frailty (OR 12.56, 95% CI 1.48-106.45; p=0.020), and polypharmacy (OR 10.41, 95% CI 1.85-59.38; p=0.008).
Conclusion:
A high prevalence of comorbidity was found in IBD, possibly related to low socioeconomic status and poor educational level.
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