P005 Trends of hospitalization in ulcerative colitis in patients in the United States from 2000 to 2014

Abstract

BACKGROUND: The prevalence of ulcerative colitis (UC) has increased over time and is one of the most important gastrointestinal causes of frequent admissions to hospital in the United States. The cost burden of UC has been steadily increasing. The primary objective of our study was to analyze patient demographics, cost burden, mortality and length of stay associated with UC hospital admissions. METHODS: Nationwide inpatient sample (NIS) database was used to identify UC discharges in all patients from 2000 to 2014 using ICD-9-CM Codes (ICD9), Principal Diagnosis: 556.0 Ulcerative Enterocolitis, 556.1 Ulcerative Ileocolitis, 556.2 Ulcerative Proctitis, 556.3 Ulcerative Proctosigmoidtis, 556.4 Pseudopolyposis Colon, 556.5 Left sided Ulcerative Colitis, 556.6 Universal Ulcerative Colitis, 556.8 Other Ulcerative Colitis, 556.9 Ulcerative Colitis Unspecified as the principal discharge diagnosis. NIS is the largest all-payer inpatient care database in the United States, containing data on more than 7 million hospital stays. It has a large sample size which is ideal for developing national and regional estimates. RESULTS: A total of 517,191,644 discharges with a diagnosis of UC were analyzed from 2000 to 2014 from the NIS database. The number of hospitalizations increased from 27,452 in 2000 to 37,565 in 2014, a 36.8% increase. In-hospital mortality decreased from 0.94% in 2000 to 0.39% in 2014, a decrease of 58.5%. Mean length of hospital stay has decreased from 6.9 days to 5.8 days (15.9% decrease) during the same period, but the mean hospital charges increased from $18,552 in 2000 to $45,465 in 2014 (145% increase). The proportion of males to females with UC is slowly trending up from 2000 to 2014. Aggregate charges increased from 0.51 billion dollars to 1.70 billion dollars. CONCLUSION(S): Overall in-hospital mortality associated with UC has decreased but the number of hospitalizations and mean cost has increased over the years. This represents a significant cost burden on the healthcare system and patients. The decrease in mortality can be attributed to early diagnosis and early institution of newer and aggressive treatments. The number of hospitalizations due to UC has been steadily increasing, and further research needs to be done on finding out the reasons for increased causes of hospitalization and ways to decrease the cost burden on patients and hospitals.