T1292 A Simple Quantitative Score to Stratify Severity of Ulcerative Colitis Hospitalizations

Abstract

Introduction: There are limited tools to stratify severity of Crohn's disease(CD) hospitalizations. Existing co-morbidity indices were developed to predict mortality, a rare outcome in this cohort. A CD-specific quantitative risk stratification tool that predicts more common and relevant outcomes such may be of greater use. Methods: We used data from the Nationwide Inpatient Sample (NIS) 2004, a national hospital discharge database, to identify CD-related hospitalizations using diagnosis codes. “Severe hospitalizations” were defined as those resulting in non-elective bowel surgery or hospitalization for longer than 7 days. Independent predictors of severity were identified through multivariate regression and assigned quantitative weights based on their regression coefficients with the sum representing the cumulative score. Results: There were 25,938 CD discharges among which 6,169(23.8%) were severe. Table 1 presents the weights of the individual components of the severity score. The cumulative severity score ranged from 0-13 points. A total of 15,330(59.1%), 9,060(34.9%) and 1,548(6.0%) discharges were classified as being low, intermediate, and high risk for severe disease respectively. The intermediate(OR 2.63, 95%CI 2.47-2.80) and high risk categories(OR 13.62, 95% CI 12.12-15.33) were associated with a significantly higher odds of severe hospitalization. The model had good discriminative capacity(AUC 0.68) for severe disease. Validation in an independent cohort of hospitalized CD patients from NIS 2007 revealed comparable performance. Existing co-morbidity indices performed poorly in predicting severe hospitalizations (AUC<0.55). Conclusion: Using administrative data, we propose a simple quantitative severity score to stratify CD hospitalizations and predict relevant CD-related outcomes. Table 1: Severity score to stratify Crohn's disease hospitalizations