IMPACT OF NON ST- ELEVATION MYOCARDIAL INFARCTION (NSTEMI) ON PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract

Abstract INTRODUCTION Inflammatory Bowel disease is a long-term illness which can lead to numerous hospital admissions and accounts for a large amount of health care costs. IBD is a pro-inflammatory state and these patients have known elevated inflammatory markers and thus there is a known association between IBD and cardiovascular disease. The aim of this study was to evaluate the economic burden and hospital outcomes associated with IBD in patients with concomintant NSTEMI. METHODS Patients aged 18 years with IBD and NSTEMI versus IBD alone were identified from the US Nationwide Inpatient Sample (NIS), from the years 2015-2019. ICD 10 codes were utilized Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics. Weighted analysis utilizing Stata 17 MP was performed. RESULTS This study identified approximately 447,300.04 patients with either UC or Crohn’s disease (IBD) from the years 2015 to 2019. Of these patients, 89,460 had a concomitant diagnosis of an NSTEMI. Mean age of patients was 56.61 years. The analysis revealed that mortality (OR 2.16, p= 0.003, CI: 1.29- 3.66), length of stay (LOS) (+2.25, p= 0.002, CI: 0.82- 3.67), and total hospital charges (THC) were all increased ($42,710.89 , p=0.000, CI: $21,379.01-$ 64,042.77) for patients with IBD and NSTEMI compared to patients with only IBD. Independent positive predictors of mortality, LOS, and increased total hospital charges were sepsis, AKI, malnutrition, and an aspiration event. CONCLUSIONS Our study revealed that patients with IBD and NSTEMI had higher mortality, hospital LOS, and total hospital charges compared to patients with only IBD. Common and overlapping inflammatory pathways contribute to that both IBD and NSTEMI which likely increases the risk for complications and mortality for these patients and demonstrated by our study. A mutli-discplinary approach should be utilized on treating patients with IBD and NSTEMI due to the significant morbidity and mortality. Further studies are needed to further evaluate the impact of NSTEMI on IBD.