MORTALITY IN INFLAMMATORY BOWEL DISEASE: A LONGITUDINAL POPULATION-BASED STUDY IN THE UNITED STATES

Abstract

Abstract INTRODUCTION Inflammatory bowel diseases (IBD) are chronic inflammatory disorders of the gastrointestinal tract. Data are limited regarding how longevity in IBD compares to the general population. The aim of this study was to compare the mean age of death and causes of mortality between patients with IBD and the general population in a nationally representative cohort. METHODS A retrospective study using 2010-2019 data from the National Readmissions Database (NRD) was performed. We identified hospitalized patients with CD and UC using International Classification of Diseases (ICD) codes. We compared the mean age of death and most common causes of mortality in CD, UC, and non-IBD patients. RESULTS The mean age of in-hospital death was significantly lower in the CD group (64.60 years) compared to the UC and non-IBD groups (67.43 and 67.07 years, respectively, p<0.01). Among all age groups, the highest death rates were among those ages 71 through 80 years of age (p<0.01). The UC group had significantly higher rates of death associated with cardiovascular causes, including myocardial infarction, congestive heart failure and cardiovascular disease, and infectious causes, including Clostridioides difficile infection and sepsis. Death rates did not significantly differ among the groups for those with diagnoses of leukemia and lymphoma (p=0.20 and p=0.19, respectively). UC patients had the highest in-hospital rate of death per year from 2010-2019, followed by the CD and non-IBD groups. Common diagnoses associated with death across all ages in the CD, UC, and non-IBD groups included fluid/electrolyte imbalance, respiratory failure, anoxic brain injury, sepsis, and renal failure. CONCLUSION While those with UC had higher in-hospital death dates, those with CD were more likely to die younger compared to the general population. UC patients were more likely to die if diagnosed with cardiovascular disorders or infections. Investigation of factors that drive premature mortality in CD patients and higher rates of mortality in UC patients is crucial to guide practice improvements and for management of co-morbid conditions. Table 1 Patient demographics and hospital characteristics. Figure 1 Death rates comparing non-IBD, CD and UC groups with specific inpatient diagnoses. * p < 0.05.