Predictors for poor outcome of hospitalized children with inflammatory bowel disease
Inflammatory bowel disease (IBD) exacerbations may lead to prolonged and complicated hospitalizations. The characteristics of exacerbation-related hospitalizations and predictors for poor outcome of pediatric patients hospitalized due to IBD have not been thoroughly described. All children who were hospitalized due to IBD exacerbation in a tertiary referral center between 2004 and 2017 were enrolled. Data on demographic and disease characteristics before and during hospitalization were retrospectively reviewed, as was the course of hospitalization, including laboratory findings, diagnostic work-up, and management. Poor outcomes were defined as prolonged hospitalization (≥ 7 days) and/or the need for surgery during hospitalization. There were 181 hospitalizations of 78 IBD children with a median (IQR) age of 14.8 (11.8–16.2) years. They included 53 (67.9%) with Crohn’s disease and 25 (32.1%) with ulcerative colitis. In a multivariate analysis, severe disease activity at hospitalization (odds ratio [OR] = 3.33, P = 0.013), lower weight percentile (OR = 0.98, P = 0.009), treatment with antibiotics (OR = 5.03, P = 0.001), blood transfusion (OR = 8.03, P = 0.003), undergoing endoscopy (OR = 2.73, P = 0.027), and imaging studies during hospitalization (OR = 3.61, P = 0.001) predicted prolonged hospitalization. Surgical intervention was performed in 16 patients (8.8%), due to penetrating (OR = 7.73, P = 0.019) and stricturing disease (OR = 12.38, P < 0.001).
What is Known:
• Inflammatory bowel disease (IBD) patients may require hospitalization due to disease exacerbation or treatment-related complications.
• Hospitalizations of IBD patients constitute a heavy emotional burden on patients and families.
What is New:
• Lower weight percentile, severe disease activity, and a lower albumin level were predictors for prolonged hospitalization in children with IBD.
• Recognition of these predictors may contribute to modification of patient management.
KeywordsChildren Hospitalization Crohn’s disease Ulcerative colitis Outcome predictors
Inflammatory bowel diseases
European Society for Pediatric Gastroenterology Hepatology and Nutrition
Pediatric CD activity index
Pediatric UC activity index
Generalized estimating equation
Magnetic resonance imaging
AYF, DS, GB, RL, ID, TZB, SC- Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation ofdata for the work; Drafting the work or revising it critically for important intellectual content; Final approval of the version to be published; Agreement to be accountable for all aspects of the work; All authors discussed the results and commented on the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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