C0416 - Short Bowel Syndrome Is Associated With Increased Morbidity and Health-Care Utilization but Not Mortality in Patients Hospitalized for Crohn’s Disease Flare: Analysis From National Inpatient Database

Sanket D. Basida, MD, Urja Nagadia, MD, Mahmoud Mansour, MD, Karthik Gangu, MD, Ebubekir Daglilar, MD
University of Missouri, Columbia, MO

Introduction: Crohn’s disease is an inflammatory disorder of the gastrointestinal tract that can affect any part of the tract, ranging from the mouth to the perianal area. Depending on the location and severity of inflammation, small bowel resections might be necessary to control disease. Short Bowel Syndrome (SBS) is a common complication arising after extensive bowel resection, especially in medically refractory Crohn’s disease. These patients are at a high risk of adverse outcomes when hospitalized. The aim of this study was to analyze the impact of SBS for patients hospitalized for Crohn’s disease flare.






Methods: All adult hospitalized patients from January 2016 to December 2019 in the nationwide inpatient sample (NIS) were captured. The sample population included all patients with a primary diagnosis of Crohn’s disease using ICD-10 codes (International Classification of Diseases, tenth edition). We then identified patients with a secondary diagnosis of SBS. The Crohn’s disease population was divided into patients with SBS (study group) and without SBS (control group). Linear regression was used for comparing continuous variables and Chi-square tests for categorical variables. Morbidity, mortality and healthcare utilization were analyzed using multivariate logistic and linear regression models where appropriate.

Results: The sample size included 374,745 patients admitted for Crohn’s disease flare, of which 99.75% did not have underlying SBS while 0.25% did. Study group had a higher incidence of Hospital-acquired pneumonia (Adjusted OR (aOR) =2.93), Catheter related blood-stream infection (aOR=7.71) and Sepsis (aOR=2.99), all with p< 0.05 or less. There was also a higher risk of hyponatremia (aOR=1.79) and Iron-deficiency anemia (aOR=1.68) in the study group. No difference was noted in venous thromboembolism rates. The adjusted mean change in hospitalization charge was $44,359 and mean change in length of stay was 6.35 days in study group vs control. Mortality though was higher in SBS group, this lost significance following multivariate analysis.

Discussion: SBS increases the risk of infections, electrolyte deficiency and anemia in patients admitted for Crohn’s disease flare but venous thromboembolism and mortality rates of both groups remains similar. This proves to be a huge burden on both the patients and the healthcare. The outcomes of patients with SBS could be greatly improved by more effective prevention of these complications, and treatment of high-risk Crohn’s patients more vigilantly.




Disclosures:


Sanket D. Basida, MD, Urja Nagadia, MD, Mahmoud Mansour, MD, Karthik Gangu, MD, Ebubekir Daglilar, MD. C0416 - Short Bowel Syndrome Is Associated With Increased Morbidity and Health-Care Utilization but Not Mortality in Patients Hospitalized for Crohn’s Disease Flare: Analysis From National Inpatient Database, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.