Abstract
Introduction: Crohn’s disease (CD) and Ulcerative Colitis (UC), the two major forms of inflammatory bowel disease (IBD), are characterized by chronic inflammation of the gastrointestinal tract. Mucosal healing is a key therapeutic goal in patients with IBD, as it has been associated with reduced risk of relapse, decreased hospital admission rates, and lower rates of major abdominal surgery. The aim of this study was to assess the proportion of patients that achieved mucosal healing within 18 months of initiation or adjustment of IBD therapy. Methods: Retrospective analysis of adults with an ICD-9/10 code diagnosis of IBD during hospitalization for IBD flare symptoms at a tertiary care center between January 1st 2013 to June 1st 2017. Patients who did not receive treatment for the IBD flare were excluded. Mucosal healing was defined as absence of ulcerations or erosions seen on colonoscopy or cross-sectional imaging (XCI). Patients were followed-up within 18-months of initiation or adjustment of IBD therapy. Data including the patients’ XCI and colonoscopy reports was extracted from the institution’s integrated electronic data repository and electronic chart review. This study was approved by the institutional review board. Results: A total of 760 unique patients were analyzed of which 519 (348 CD, 160 UC, 11 indeterminate) met inclusion criteria. The cohort consisted of the characteristics outlined in Table 1. Of these 519 patient records, 118 (22.7%) had both XCI and colonoscopy during hospitalization, 178 (34.3%) had XCI and 72 (13.9%) had colonoscopy. One hundred and seventeen patients (102 CD, 14 UC, 1 indeterminate) had follow-up at 18-months. The follow-up cohort consisted of the characteristics outlined in Table 1.Of these, 22 (18.8%) had both XCI and colonoscopy, 67 (57.2%) had XCI and 26 (22.2%) had colonoscopy. Mucosal healing was achieved in 70/117 (59.8%) patients. In CD, 61/102 (59.8%) achieved mucosal healing and in UC, 9/14 (64.3%) achieved mucosal healing. Conclusion: Mucosal healing was achieved in over half of patients within 18-months of initiation or adjustment of IBD therapy. Mucosal healing was achieved in similar proportions of CD and UC patients at 18-months.Table 1.: Patient characteristics associated with loneliness and social isolation
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