Metabolic Comorbidities and Hospital Outcomes in Patients With Inflammatory Bowel Disease: A Nationwide Analysis

This study aimed to evaluate the impact of MetS on inpatient outcomes, health care utilization, and discharge patterns in hospitalized IBD patients.

Inflammatory bowel disease (IBD) is a chronic, immune-mediated condition associated with rising prevalence, high hospitalization rates, and substantial health care costs. In parallel, the growing burden of metabolic syndrome (MetS) may further worsen clinical outcomes and resource utilization in this population.

We conducted a retrospective analysis of the 2016-2020 National Inpatient Sample, identifying 241,772 hospitalized IBD patients. Patients were stratified by the presence of MetS, and the 2 cohorts were compared regarding inpatient outcomes including mortality, intensive care interventions, length of stay (LOS), and discharge disposition. Multivariable logistic regression models were used to assess associations between MetS, its individual components (hypertension, diabetes, obesity, and dyslipidemia), and key inpatient outcomes.

Of the cohort, 6382 (2.6%) had MetS. Compared with patients without MetS, those with MetS were older, had higher comorbidity burden, longer LOS (5.77 vs 5.30 d), and increased likelihood of central line placement, intubation, and vasopressor use. Discharge to home was less frequent (57.4% vs 73.7%), with higher rates of skilled nursing or home health needs. Multivariable analysis demonstrated that MetS and individual components independently increased odds of mortality, intensive care interventions, and resource utilization.

MetS significantly worsens inpatient outcomes and increases health care utilization in hospitalized IBD patients. Early identification and targeted management of metabolic comorbidities may reduce complications, optimize resource use, and improve discharge outcomes, underscoring the importance of integrated metabolic care in this population.