E0389 - Decreased Odds of Hospitalization for Octogenarian Patients With IBD

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Mohammad Afsh, BA

California University of Science and Medicine
Rancho Cucamonga, CA

Mohammad Afsh, BA¹, Pedro Palacios Argueta, MD², Jana G. Hashash, MD, MSc³, Francis A. Farraye, MD, MSc², Paul Kröner, MD, MS³
¹California University of Science and Medicine, Colton, CA; ²Mayo Clinic, Jacksonville, FL; ³Mayo Clinic Florida, Jacksonville, FL

Introduction: Incidence of inflammatory bowel disease (IBD) decreases after the second incidence peak of patients aged 50-70 years. Patients over 80 years represent 10% of the IBD patient population. Disease course for elderly patients in both ulcerative colitis (UC) and Crohn’s disease (CD) has been noted to be milder, with less bleeding, less progression to penetrating disease and less occurrence of extraintestinal manifestations. Inpatient outcomes in this patient cohort have not yet been thoroughly explored. The aim of this study was to examine inpatient outcomes in octogenarian patients admitted for IBD using a national database.

Methods: Retrospective, observational study using the National Inpatient Sample (NIS) 2018. All patients with principal ICD10CM codes for IBD were included. The cohort was divided into two age groups: >80 years old and < 80 years old. The cohort was further substratified into UC and CD. Primary outcome was determining the occurrence and odds of admission for IBD in octogenarian patients compared to patients younger than 80 years. Secondary outcomes included inpatient morbidity, mortality, colectomy odds, hospital length of stay (LOS), and total hospital costs and charges. Multivariate regression analyses were used to adjust for confounding variables.

Results: A total of 99,530 patient admissions for IBD were included in the study (39% UC). Of these, 4,245 (4.27%) were >80y/o (63% UC). The mean age in the octogenarian cohort was 84.7 years and 68% were female. A greater proportion of Caucasian octogenarians were noted compared to the cohort younger than 80 years (84.55% vs 71.54%, respectively). Octogenarian patients with IBD were noted to have lower odds of admission (aOR:0.32, p< 0.01), compared to non-octogenarian patients with IBD. Octogenarian patients with IBD displayed lower odds of colectomy, while octogenarian patients with CD had lower odds of ICU admission compared to non-octogenarian patients. There were no differences in resource utilization noted between the two cohorts (Table 1).

Discussion: Octogenarians admitted for IBD primarily had a diagnosis of UC and 68% were female. As suggested by prior studies noting a lesser disease severity in this age group, octogenarians displayed decreased odds of admission for IBD, as well as decreased odds of ICU admission compared to non-octogenarian patients with IBD. Future studies should focus on directly assessing disease severity in this patient cohort to better understand its relationship with inpatient outcomes.

	Adjusted Odds Ratio	95% Confidence Interval	p-value
IBD Admission Crohn's Disease Ulcerative Colitis	0.32 0.20 0.47	0.30-0.35 0.18-0.23 0.43-0.52	< 0.01 < 0.01 < 0.01
Mortality Crohn's Disease Ulcerative Colitis	0.75 0.43 1.21	0.34-1.68 0.11-1.71 0.42-3.49	0.49 0.23 0.72
Shock Crohn's Disease Ulcerative Colitis	0.55 0.39 0.74	0.29-1.03 0.14-1.12 0.33-1.68	0.06 0.08 0.47
AKI Crohn's Disease Ulcerative Colitis	0.84 0.54 0.88	0.68-1.05 0.60-1.16 0.65-1.18	0.13 0.29 0.38
ICU Crohn's Disease Ulcerative Colitis	0.43 0.41 0.50	0.23-0.80 0.17-0.98 0.51-1.22	< 0.01 0.05 0.13
SIRS Crohn's Disease Ulcerative Colitis	0.68 0.19 1.01	0.33-1.39 0.02-1.43 0.45-2.30	0.29 0.11 0.98
Multiorgan Failure Crohn's Disease Ulcerative Colitis	0.89 0.79 1.01	0.72-1.10 0.57-1.10 0.76-1.33	0.30 0.16 0.96
Colectomy Crohn's Disease Ulcerative Colitis	0.30 0.08 0.42	0.18-0.48 0.02-0.34 0.24-0.73	< 0.01 < 0.01 < 0.01
	Non-Octogenarians	Octogenarians	p-value
Mean Costs (USD$) Crohn's Disease Ulcerative Colitis	$12,153 $11,731 $12,849	$11,329 $10,496 $11,814	0.94 0.44 0.64
Mean Charges (USD$) Crohn's Disease Ulcerative Colitis	$49,549 $47,617 $52,734	$48,446 $45,901 $49,927	0.63 0.58 0.76
Mean LOS (days) Crohn's Disease Ulcerative Colitis	5.0 4.9 5.1	5.6 5.3 5.8	0.13 0.73 0.09

Table: Table 1 – Adjusted Odds Ratios and Means for Octogenarian Patients with IBD Compared to Non-Octogenarian Patients with IBD.

IBD - Inflammatory Bowel Disease, AKI - Acute Kidney Injury, ICU - Intensive Care Unit, SIRS - Systemic Inflammatory Response Syndrome, LOS - Length of Stay.

Disclosures:

Mohammad Afsh indicated no relevant financial relationships.

Pedro Palacios Argueta indicated no relevant financial relationships.

Jana Hashash indicated no relevant financial relationships.

Francis Farraye: Adiso Therapeutics – DSMB. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. GSK – Advisory Committee/Board Member. IBD Educational Group – Advisory Committee/Board Member. Innovation Pharmaceuticals – Stock Options. Iterative Scopes – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Lilly – DSMB. Pfizer – Advisory Committee/Board Member. Sebela – Advisory Committee/Board Member. Theravance – DSMB.

Paul Kröner indicated no relevant financial relationships.

Mohammad Afsh, BA¹, Pedro Palacios Argueta, MD², Jana G. Hashash, MD, MSc³, Francis A. Farraye, MD, MSc², Paul Kröner, MD, MS³. E0389 - Decreased Odds of Hospitalization for Octogenarian Patients With IBD, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.