Rowan University School of Osteopathic Medicine, Jefferson Health NJ Voorhees Township, NJ, United States
Neethi R. Dasu, DO1, Yaser Khalid, DO2, Brian Blair, DO3, Lucy Joo, DO4 1Rowan University School of Osteopathic Medicine, Jefferson Health NJ, Voorhees Township, NJ; 2Wright Center for Graduate Medical Education, Davie, FL; 3Thomas Jefferson University, Cherry HIll, NJ; 4Thomas Jefferson University Hospital, Cherry HIll, NJ
Cirrhosis is an under-studied complication in patients with Inflammatory Bowel Disease (IBD). There is a scarcity of data on the influence of sex, race, insurance status on mortality, hospital length of stay (LOS), and total hospital charges for patients with IBD and cirrhosis compared to patients with cirrhosis. The aim of this study was to identify risk factors in a national population cohort admitted to US hospitals in the years 2012-2018.
Methods: All patients aged 18 years and above with IBD and Cirrhosis, were identified from the US Nationwide Inpatient Sample. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics.
Results: Our study identified approximately 916,805 patients, 18,887 with IBD and Cirrhosis versus 897,918 with only Cirrhosis from 2012-2018. The analysis revealed that differences in mortality [OR 1.07 (1.01-1.14), p< 0.024], length of stay (LOS) [OR 1.02 (1.01-1.03), p< 0.0001], and total hospital charges [OR 1.02 (1.01-1.03), p< 0.0001] were statistically significant for patients with IBD and Cirrhosis compared to patients with only Cirrhosis. Black race [OR 1.39 (1.14-1.69), p< 0.001], male gender [OR 1.24 (1.10-1.41), p< 0.001], self pay insurance [ OR 1.56 (1.18-2.06), p< 0.002], ascites [ OR 1.77 (1.57-2.02), p< 0.0001 ], hepatorenal syndrome (HRS) [OR 2.06 (1.76-2.40), p< 0.0001] ) and hepatic encephalopathy (HE) [OR 2.06 (1.76-2.40), p< 0.0001] were positive predictors for mortality. Portal hypertension [OR 1.68 (1.20-2.35), p< 0.003], and HE [OR 2.06 (1.12-3.81), p< 0.021 ] were positive predictors for increased LOS. Those with Variceal bleeding [OR 0.703 (0.51-0.98)] had a shorter LOS.
Discussion: In patients with IBD and Cirrhosis, factors that portend an increase in mortality include the presence of black race, male gender, HRS, HE, ascites, and self pay-insurance. Patients with IBD and cirrhosis with concomitant portal hypertension and HE had an increased hospital stay. To our knowledge, this is the first study to compare these variables in this patient population. More randomized clinical trials are required to compare patients in these populations and institute appropriate care and to decrease the mortality and the immense financial burden on the healthcare system.
Neethi Dasu indicated no relevant financial relationships.
Yaser Khalid indicated no relevant financial relationships.
Brian Blair indicated no relevant financial relationships.
Lucy Joo indicated no relevant financial relationships.
Neethi R. Dasu, DO1, Yaser Khalid, DO2, Brian Blair, DO3, Lucy Joo, DO4. P2847 - Cirrhosis and Inflammatory Bowel Disease: A Model to Predict Mortality and Hospital Length of Stay, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.