S20 Impact of Anxiety on Patients With IBD: Insights From the National Inpatient Database (NIS)- 2015-2019

Abstract

Background: Inflammatory Bowel Disease (IBD) can have numerous complications involving all systems of the body. People with inflammatory bowel disease (IBD) are at increased risk of developing mental health disorders, such as anxiety. The aim of our study was to examine the impact of anxiety on the outcomes of patients with IBD. Methods: The Nationwide Inpatient Sample (NIS) database encompasses approximately 7 million inpatient hospitalizations annually in the United States. Data were extracted from the National Inpatient Sample (NIS) Database for the years 2015-2019. Patients aged 18 years and above with diagnoses of IBD and anxiety were identified using ICD codes. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay (LOS), and hospital charges using STATA 17. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: We identified 1,198,839 patients with IBD of which 235,880 patients were matched to those with anxiety. Average age was 52.04 years. There was a significant decrease in inpatient mortality (OR 0.56, CI 0.51-0.62, P < 0.0001) and total cost of hospitalization (-$3,242.13, CI -4,259.55 - -2224.70, P < 0.0001), but hospital length of stay increased (0.27 days, CI 0.20-0.34, P < 0.0001) between patients with IBD with cannabis use when compared to IBD patients without cannabis use. Conclusion(s): The different clinical manifestations and symptoms of IBD may cause several psychological changes in patients. Past studies demonstrated that psychological stress and disorders can trigger flares and relapses in patients with IBD. Our study showed that there was a statistically significant decrease in inpatient mortality and hospital LOS for patients with both IBD and anxiety compared to those with only IBD. Anxiety is known to be 2 to 3 times higher in patients with IBD, but it reduces morbidity and mortality. This may be due to the increased surveillance and treatment to this subgroup of patients. Given the known association between IBD and anxiety, clinicians be vigilant in detecting and treating concomitant anxiety as this could lead to better outcomes in this patient population, as our study revealed. Future randomized control trials are needed to further study the impact of anxiety on IBD.