Journal of Gastrointestinal Surgery

, Volume 15, Issue 2, pp 267–276

A Nationwide Analysis of Changes in Severity and Outcomes of Inflammatory Bowel Disease Hospitalizations

  • Ashwin N. Ananthakrishnan
  • Emily L. McGinley
  • David G. Binion
  • Kia Saeian
Original Article

DOI: 10.1007/s11605-010-1396-3

Cite this article as:
Ananthakrishnan, A.N., McGinley, E.L., Binion, D.G. et al. J Gastrointest Surg (2011) 15: 267. doi:10.1007/s11605-010-1396-3

Abstract

Introduction

The past decade has seen a change in inflammatory bowel disease (IBD; Crohn's disease (CD) and ulcerative colitis (UC)) treatment, with increasing use of immunomodulators and biologics. The impact of this on IBD hospitalization outcomes is unknown.

Methods

We identified hospitalizations with a diagnosis of IBD using data from the Nationwide Inpatient Sample, a national US discharge database. We compared the proportion of hospitalizations resulting in surgery in the entire cohort and within each disease severity stratum for the years 1998, 2004, and 2007.

Results

There were an estimated 89,673 hospitalizations for CD in 1998 increasing to 150,593 hospitalizations in 2007. UC hospitalizations increased from 56,911 in 1998 to 86,611 in 2007. This increase was primarily among low or intermediate severity hospitalizations not requiring surgery. For CD, the proportion of bowel surgeries during hospitalization decreased from 17.3% in 1998 to 12.4% in 2007 (p < 0.001) while for UC, the proportion of colectomy decreased from 9.5% in 1998 to 6.2% in 2007 (p < 0.001). For both diagnoses, this reduction was significant in those with a low severity of disease but not with in those with the highest severity stratum.

Conclusions

There continues to be an increase in the number of hospitalizations in patients with IBD. The numbers of non-elective bowel surgeries among those with the highest severity of disease continues to increase suggesting need for further research into improving outcomes in this cohort at high risk for adverse outcome.

Keywords

Inflammatory bowel disease IBD Crohn’s disease Ulcerative colitis Hospitalization, surgery, colectomy 

Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Ashwin N. Ananthakrishnan
    • 1
    • 4
  • Emily L. McGinley
    • 2
  • David G. Binion
    • 3
  • Kia Saeian
    • 1
  1. 1.Division of Gastroenterology and HepatologyMedical College of WisconsinMilwaukeeUSA
  2. 2.Division of EpidemiologyMedical College of WisconsinMilwaukeeUSA
  3. 3.Division of Gastroenterology, Hepatology and NutritionUniversity of Pittsburgh School of MedicinePittsburghUSA
  4. 4.Gastrointestinal UnitMassachusetts General HospitalBostonUSA

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