S1334 Do Geriatric Patients Admitted With a Primary Diagnosis of Celiacs Disease Have a Higher Rate of Complications and Mortality Compared to Their Younger Counterparts?

Abstract

Introduction: As the incidence of Celiac disease in the geriatric population increases, it is important to understand the disease course and specific complications they may be predisposed. The nuanced symptomatic presentation in the elderly can lead to severe complications as a result of delayed diagnosis. The aim of this study was to determine the rate of common complications and mortality of elderly patients as compared to younger patients admitted to the hospital with a primary diagnosis of Celiac disease. Methods: The National Inpatient Sample 2001-2013 database was queried for patients with a diagnosis of Celiac Disease using International Classification of Diseases, Ninth Revision (ICD-9) codes. Myocardial Infarctions, Pneumonia, Urinary Tract Infections, and Acute Renal Failure were identified with their respective ICD-9 codes. A chi-square analysis was performed to determine variables to be included in a multivariable analysis. A binary logistic regression analysis was used to examine demographic and other important variables, with a significance level of P < 0.001. Results: A total of 87,823 patients were identified with Celiac, of which 25,818 (29.4%) were age 65 or older. After incorporating demographic variables and social variables, such as biological sex, the geriatric population had a significantly higher likelihood of having a myocardial infarction (OR = 2.82), pneumonia (OR = 1.72), urinary tract infection (OR = 1.61), malnutrition (OR = 1.19), and acute renal failure (OR = 2.18). Geriatric patients with Celiac Disease had a significantly higher likelihood of dying during the hospital stay (OR = 10.24). Conclusion: There are many age-related differences in the presentation and clinical course of Celiac disease between the younger adult and geriatric population. The elderly population was found to be more likely to experience life-threatening complications as a result of Celiac disease. A greater understanding of factors contributing to the more complicated clinical courses of Celiac disease in the elderly is needed to improve quality of life and morbidity and mortality in this population. The markedly high likelihood of mortality in this population should be further investigated to prevent treatable causes of death.Figure 1.: Predictors of Complications in Geriatric Patients Admitted Primarily for Celiac Disease.