828 Effect of Obesity on Venous Thromboembolism-Related Morbidity Among Hospitalized Patients With Inflammatory Bowel Disease: A Nationwide Population Study

Abstract

INTRODUCTION: Obesity and inflammatory bowel disease (IBD) have been associated with an increased risk of venous thromboembolism (VTE). Limited data exists related to the effect of obesity on IBD-related complications, including VTE. The aim of our study was to assess the effect of obesity on VTE-related outcomes among patients with IBD. METHODS: All adults hospitalized with IBD and VTE during the years 2010 to 2014, were identified using the Nationwide Inpatient Sample (NIS). These patients were divided into two groups: patients who were overweight, obese or morbidly obese (study group) and those with a normal BMI (control group). We compared demographics, inpatient mortality, length of stay and total charges among both these groups. RESULTS: During the five-year study period, there were 295,592 hospitalizations for patients with IBD who also had a co-diagnosis of VTE. Compared with non-obese controls, obese patients were older (mean age 58.72 years vs 55.02 years; P < 0.001) and more likely to be females (53.24% vs 44.94%; P = 0.001). Patients in both groups were predominantly White (71.14% vs 73.17%) compared to African Americans (12.79% vs 13.49%) and Hispanics (11.25% vs 7.97%); P = 0.001. Comorbidities such as diabetes (45.55% vs 25.95%; P = 0.001) and hypertension (67.49% vs 55.97%; P = 0.001) were more prevalent in the obese group. Rates of colectomy were higher (3.98% vs 0.94%; P = 0.003) among obese patients. Complications associated with pulmonary embolism (PE) such as cardiogenic shock (1.16 vs 0.11; P = 0.67), right heart failure (9.83% vs 5.45%; P = 0.002) and respiratory failure (19.06% vs14.66%; P = 0.001) were also higher in the obese group of patients. Length of stay (9.72 days vs 5.18 days; P < 0.001), inpatient mortality (2.32% vs 1.11%; P < 0.001) as well as total cost of hospitalization ($21,469 vs $17,291; P = 0.001) were all higher among obese IBD patients with VTE as compared to non-obese controls. On multivariate logistic regression, obesity was an independent predictor of length of stay (OR 0.13 [0.10-0.16]; P < 0.001) and inpatient mortality (OR 1.78 [1.61-1.99]; P < 0.001) among hospitalized IBD patients with VTE. CONCLUSION: Obesity is associated with a significantly higher rate of VTE-related morbidity and mortality among patients with IBD. The total cost of hospitalization among these patients is also higher compared to non-obese individuals. Our study identifies obesity as a risk factor leading to poorer outcomes among IBD patients who are hospitalized with VTE.