S0729 All-Cause Hospitalization Rates Among IBD Patients in a Tertiary-Care Academic Hospital

Abstract

INTRODUCTION: Studies have shown that the hospitalization rates for inflammatory bowel disease (IBD) patients in the United States have been increasing over the last decades despite advanced therapies. Some studies have investigated the reasons for inpatient admissions of IBD patients in specific populations, i.e. Veteran affair and pediatric hospitals, however few exist looking at hospitalization trends in general IBD patients in an academic hospital. METHODS: A list of IBD patients seen in outpatient clinics who were also hospitalized at Thomas Jefferson University Hospital from 11/01/2014 to 11/01/2019 was compiled. Via retrospective chart review, the data was analyzed for admission reason (IBD flare, IBD-related surgery/complication, IBD-related infection, or IBD-nonrelated). Average length of stay (LOS) for each reason was analyzed with ANOVA. Length of stay was also analyzed in ulcerative colitis (UC) admissions versus Crohn's disease (CD) and compared with t-test. The identified patients were then further divided by number of admissions (either 1, 2–3, or 3+) to characterize recurrent admissions. RESULTS: A total of 65 patients were identified for a total of 115 total admissions. The main reasons for admissions were found to be IBD flares (46.9%), IBD surgical procedures/surgical complications (20.0%), IBD-related infections (13.0%) and all other causes (20.0%). The average admission LOS was 5.0 ± 5.2 days, with LOS for specific reasons being: 4.7 ± 2.9 days for IBD flares, 4.4 ± 4.9 days for IBD surgeries/complications, 7.6 ± 10.5 days for IBD-related infections, and 4.5 ± 6.6 days for other causes. ANOVA revealed no statistical significance in LOS difference between all groups (P = 0.23). In total there were 94 CD admissions and 21 UC admissions, with an average LOS of 4.7 ± 4.9 days for CD and 6.3 ± 6.4 days for UC, but no significance on t-test (P = 0.10). 60.0% of patients had only 1 admission, 32.3% had 2-3, and 7.6% had 3+. CONCLUSION: High IBD admission rates cause a significant burden on healthcare costs. Our findings identified IBD admission trends in an academic center to understand why patients are being admitted, length of stay, and readmission rates. Studies from abroad have shown that interventions such as an IBD-patient-helpline reduce IBD-related admission rates. Given that majority of admissions are due to IBD complications with an average LOS of ∼5 days, future research would focus on a quality-improvement approach to reduce IBD-related admissions.Table 2.: This table shows the number of total Crohn's disease (CD) admissions and the total number of ulcerative colitis (UC) admissions for the 65 examined patients. The table also shows the average length of stay for each IBD sub-typeFigure 1.: This figure shows the percentage of number of admissions each patient with IBD has, and shows that majority (60%) have only 1 admission, but 40% have had re-admissions with nearly 8% having 3 or more admissions.Table 1.: This table shows reasons for admission, as well as the percentage of total admissions for that reason and the average length of stay (LOS) for each. IBD related infections had the longest LOS and the average total LOS for IBD admissions was 5 days