P130 LEADING CAUSES OF MORTALITY IN INFLAMMATORY BOWEL DISEASE: A NATIONWIDE ANALYSIS

Abstract

Abstract Background Patients with inflammatory bowel diseases (IBD) often ask whether their condition would affect their life span. However, available data are sparse. The aims of this study were to compare the ages of death between patients with and without IBD and to determine the leading causes of death amongst inpatients with IBD in a large nationwide database. Methods The Nationwide Readmissions Database (NRD) provides a nationally representative sampling of patient-linked hospitalizations throughout the United States. For years 2010 through 2016, we identified individuals with Crohn’s disease (CD) or ulcerative colitis (UC) based on International Classification of Diseases-Clinical Modification codes, ninth and tenth revisions (ICD-9, ICD-10). The mean age of death was compared between IBD and non-IBD inpatients. Cluster analyses were used to evaluate the leading causes of death among IBD patients based on the associated codes in the first three diagnosis positions. Results Between 2010 and 2016, there were 934,331 CD and 623,596 UC patients admitted. There were more deaths associated with UC than CD (3.11% vs. 1.72%; P <0.01) (Figure 1). Amongst CD patients, the average age of death was 68.2 years, compared to 70.5 years for non-IBD patients (P <0.01). For UC patients, the average age of death was 71.9 years, compared to 70.5 years for non-IBD patients (P <0.01). The most frequent diagnoses for CD patients who died while hospitalized were sepsis (31.1%), respiratory failure (13.0%), and fluid electrolyte and acid-base disorders (12.5%) (Table 1). Interestingly, motor vehicle accidents were associated with a significant number of deaths among CD patients (7.0%). Pre-defined diagnoses of interest associated with death included myocardial infarction (3.3%), deep vein thrombosis/pulmonary embolism (2.0%), and malignancy (6.7%). Diagnoses most frequently noted in UC patient who died while inpatient included sepsis (43.4%), fluid electrolyte and acid-base disorders (13.6%), and respiratory failure (10.9%). Similarly to CD, motor vehicle accidents were again associated with a significant number of UC deaths (5.5%). Pre-defined diagnoses associated with death in UC included myocardial infarction (3.5%), deep vein thrombosis/pulmonary embolism (2.0%), and malignancy (5.8%). Conclusions In a large nationally representative database of hospitalized patients, although those with CD and UC were found to have statistically significant differences in age at death when compared with the general population, the absolute differences were small. Diagnoses most frequently associated with inpatient mortality were sepsis, respiratory failure, and fluid electrolyte and acid-base disorders. There was also a large number of motor vehicle-related deaths among IBD patients.