13-year mortality trends among hospitalized patients with inflammatory bowel disease

BMC Gastroenterology

Research Article

Hal F Yee¹  Justin L Sewell¹ 

[1] Center for Innovation in Access and Quality, Department of Medicine, Division of Gastroenterology and Hepatology, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA;

关键词: Inflammatory bowel disease;    Crohn’s disease;    Ulcerative colitis;    Hospitalization;    Epidemiology;    Mortality;    In-hospital mortality;    Outcomes;   

DOI  :  10.1186/1471-230X-12-79

 received in 2011-12-19, accepted in 2012-06-18,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundStudies document increasing rates of hospitalization among patients with inflammatory bowel disease, but temporal trends for in-hospital mortality among patients with inflammatory bowel disease are not characterized. We sought to determine whether in-hospital mortality changed over a 13-year period among nationwide hospitalizations associated with inflammatory bowel disease. We additionally sought to identify factors correlated with mortality.MethodsWe used the National Hospital Discharge Survey, a large nationally representative database, for the years 1994 through 2006. Age- and mortality-adjusted rates of in-hospital mortality and standardized mortality ratios were calculated for four time periods. Logistic regression analysis was used to assess associations between advancing time and mortality in adjusted analyses.Results150 (0.9%) of 17,393 hospitalizations for patients with inflammatory bowel disease ended in death. Age-adjusted in-hospital mortality decreased from 3.6 deaths per 1,000 hospital days in 1994–96 to 2.4 per 1,000 in 2003–06; standardized mortality ratio decreased from 0.33 to 0.27. Similar trends were seen for patients with ulcerative colitis, but mortality did not change over time among patients with Crohn’s disease. Multivariable logistic regression analysis confirmed the significance of these changes in mortality, with 17% decreased odds of in-hospital death per three-year period (P = 0.012). Subject age (OR 1.06 per year, P < 0.001), Charlson comorbidity index (OR 1.29 per 1-point increase, P < 0.001), and diagnosis of ulcerative colitis (versus Crohn’s disease, OR 1.41, P = .042) were also associated with in-hospital mortality.ConclusionsThe odds of in-hospital mortality among hospitalized patients with inflammatory bowel disease decreased by 17% per 3-year period from 1994 to 2006 in analysis adjusted for age and comorbidity status, in this large, nationally representative database. Multiple factors likely contribute to these trends.

【 授权许可】

CC BY   
© 2012 Sewell and Yee et al.; licensee BioMed Central Ltd. 2012