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S1154 Urgently Hospitalized Inflammatory Bowel Disease Patients During the Pandemic Had Higher Rates of Complications Independent of COVID19 Infection
Abstract   Peer reviewed

S1154 Urgently Hospitalized Inflammatory Bowel Disease Patients During the Pandemic Had Higher Rates of Complications Independent of COVID19 Infection

Rama Nanah, M Housam Nanah, Robana Nanah, Osama Hamid, Ahmed Eltelbany, Faris Hammad, Yazan Abu Omar, George Khoudary and Miguel Regueiro
The American journal of gastroenterology, Vol.118(10S), pp.S883-S884
10/2023
DOI: 10.14309/01.ajg.0000954256.01356.d4

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Abstract

Introduction: During COVID19 pandemic, most outpatient care in the US became virtual. This change has affected hospitalizations with some studies reporting decreased inflammatory bowel diseases (IBD) related admissions. There is scarcity of information regarding urgent hospital admissions of IBD patients and its outcomes during the pandemic. In this study, we aim to examine the outcomes of urgently hospitalized IBD patients during the pandemic to better understand the effect the quality of outpatient care has on hospital admissions. Methods: This is a retrospective cohort analysis using the Nationwide Inpatient Sampling database from 2017 to 2020. The pandemic was defined by the period between April 2019 and December 2020 and the pre-pandemic period was selected to be Jan 2017 to March 2019. We identified adult patients with a primary discharge diagnosis of IBD. We excluded elective admissions. The study population was further divided into Ulcerative (UC) and Crohn's (CD) Results: We identified a total of 307,375 urgently admitted IBD patients. Out of which, 118,265 had UC and 189,110 had CD. Out of UC admitted during the pandemic, 270 patients had a secondary diagnosis of COVID19 (0.54%) vs (0.4%) in CD.UC patients admitted during the pandemic had statistically significantly higher hyperlipidemia (HLD) (21.7% vs 19.9%), chronic kidney disease (CKD) (7.4% vs 6.3%) diabetes (DM) (15.1% vs 14%), Obesity (10.9% vs 9.3%) and smoking (23.3% vs 24.3%) while CD patients had statistically significantly higher hypertension (28.8% vs 27.6%), HLD (11.2% vs 13%), CKD (5.6% vs 4.5%) DM (9% vs 8.11%), Obesity (10.8% vs 8.9%), smoking (23.3% vs 24.3%). When adjusting for demographics and comorbidities, including COVID19 infection, UC patients admitted during the pandemic had higher odds of bowel obstruction (OR 1.22 CI 1.02-1.47), gut perforation (OR 1.33 CI 1.04-1.71), mechanical ventilation (OR 1.94 CI 1.24-3.03) and acute kidney injury (AKI) (OR 1.14 CI 1.04-1.25) While CD patients had higher odds of bowel obstruction (OR 1.22 CI 1.12-1.33), mechanical ventilation (OR 2.01 CI 1.21-3.33), shock 1.41 (OR 1.05-1.89), AKI (OR 1.11 CI 1.02-1.21) and mortality (OR 1.06 CI 1.05-1.08). Conclusion: Urgently admitted UC and CD patients during the pandemic had higher rates of comorbidities and complications including bowel obstruction, mechanical ventilation, and AKI . Although our study could not determine causality for worse outcomes, we speculate that a delay in care during the pandemic may be related (Table 1).

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