P1163 Incidence and risk of hip replacement rate in patients with inflammatory bowel disease in Taiwan

Abstract

Abstract Background The incidence and prevalence of inflammatory bowel disease (IBD) are low but increasing in Taiwan. Management of comorbidities such as osteoporosis is becoming increasingly important in treating patients with IBD. Hip fracture is the most serious consequence of low bone mineral quality and is associated with excess risk of mortality. The present study aimed to investigate the total/partial hip replacement in IBD patients in Taiwan. Methods In a matched nationwide cohort study, we evaluated the risk of total/partial hip replacement in IBD patients. We conducted univariable and multivariable Cox models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The Kaplan-Meier curves were plotted to describe the cumulative incidence of hip replacement among the two cohorts. Results a total of 51,301 patients with IBD and 153,903 patients without IBD were included in this study. In Table 1, distribution of gender, age, comorbidities, and medications were similar between two cohorts (SMD<0.1), except stroke, renal insufficiency, steroid, 5-ASA and anti-osteoporotic agents. The mean (standard deviation) age was 51.00 (17.76) and 49.89 (16.85) years and the sex ratio between female and male was approximately 50% and 50% in two cohorts, respectively. As shown in Table 2, patients with IBD had a significantly higher risk of hip replacement than the control group (adjusted HR=1.11, 95% CI=1.03-1.19). For the sake of a visual picture of cumulative incidence of hip replacement, consider the graphic representation in Figure 1 (Kaplan-Meier plot). Compared to female individuals, male individuals had significantly lower risks of hip replacement (adjusted HR=0.73, 95%CI=0.68-0.78). Older patients had more risk of hip replacement. Individuals aged 40-59, aged 60-79, aged >79 had significantly higher risks of hip replacement (adjusted HR >1, p-value<0.05) compared to individuals aged 20-39. Table 3 showed that IBD patients who are females, aged 40-59, or steroid users tended to have a higher risk of hip replacement compared to individuals without IBD (adjusted HR > 1, p-value < 0.05). We further stratified different dose of steroid use in IBD and non-IBD cohorts in Table 4. IBD patients receiving different steroid doses did not show influence on the risk of hip replacement. We demonstrated no difference in the hospital days, mortalities and morbidities among patients with hip replacement in non-IBD and IBD cohorts in Table 5. Higher rate of GI bleeding in IBD group had a significant difference than non-IBD group.; Conclusion Our present results indicate that patients with IBD had an overall higher total/partial hip replacement in Taiwan.