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Fracture-Associated Hospitalizations in Patients with Inflammatory Bowel Disease

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Abstract

Background

Maintenance of bone health is an important concern in patients with inflammatory bowel disease (IBD). They may frequently have impaired bone density resulting in greater incidence of fractures.

Aims

To examine fracture-associated hospitalization costs in IBD patients from a nationwide representative sample, and to compare the risk factors for such fractures in IBD and non-IBD patients.

Methods

We identified discharges with IBD and coexisting codes for hip, vertebral or wrist fractures (IBD-Fr) from the Nationwide Inpatient Sample and compared them with IBD hospitalizations without codes for these fractures. A second analysis was performed using 2008 inpatient data from the Wisconsin Hospital Association (WHA) comparing characteristics of patients with IBD-Fr and non-IBD controls hospitalized for similar fractures.

Results

There were 1,653 discharges in the IBD-Fr group accounting for 10,461 days of hospital stay and US $46 million in total hospitalization charges. On multivariate analysis, age >65 years [odds ratio (OR) 28.8, 95% confidence interval (CI) 12.3–67.6] and female sex (OR 1.3, 95%CI 1.0–1.6) were associated with higher odds of hospitalization associated with fractures. We found no differences in age, gender, or race among IBD-Fr and non-IBD fracture controls. However, IBD-fractures were twice as likely to be associated with osteoporosis as non-IBD fractures (OR 2.19, 95%CI 1.10–4.33).

Conclusions

Older age, female sex, and osteoporosis were more commonly associated with hospitalization for fractures in IBD patients. Osteoporosis appears to be more common among IBD-Fr patients than non-IBD fracture controls.

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Acknowledgment

This work was presented in part at the Digestive Disease Week, May 1–5, 2010, New Orleans, LA.

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Authors and Affiliations

  1. Gastrointestinal Unit, Massachusetts General Hospital, 165 Cambridge Street, 9th Floor, Boston, MA, 02114, USA

    Ashwin N. Ananthakrishnan

  2. Division of Epidemiology, Medical College of Wisconsin, Milwaukee, WI, USA

    Emily L. McGinley

  3. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    David G. Binion

  4. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA

    Kia Saeian

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  1. Ashwin N. Ananthakrishnan
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  2. Emily L. McGinley
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  3. David G. Binion
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  4. Kia Saeian
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Correspondence to Ashwin N. Ananthakrishnan.

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Ananthakrishnan, A.N., McGinley, E.L., Binion, D.G. et al. Fracture-Associated Hospitalizations in Patients with Inflammatory Bowel Disease. Dig Dis Sci 56, 176–182 (2011). https://doi.org/10.1007/s10620-010-1433-9

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  • DOI: https://doi.org/10.1007/s10620-010-1433-9

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