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- Title
Analysis of Hospital-Based Emergency Department Visits for Inflammatory Bowel Disease in the USA.
- Authors
Gajendran, Mahesh; Umapathy, Chandraprakash; Loganathan, Priyadarshini; Hashash, Jana; Koutroubakis, Ioannis; Binion, David; Hashash, Jana G; Koutroubakis, Ioannis E; Binion, David G
- Abstract
<bold>Background: </bold>Inflammatory bowel disease (IBD) is a chronic, debilitating condition with high emergency department (ED) utilization. We aimed to investigate the utilization patterns of ED by IBD patients and measure hospitalization and surgical rates following ED visits.<bold>Methods: </bold>We conducted a cross-sectional study of adults with IBD listed as the primary ED diagnosis from the 2009 to 2011 Nationwide Emergency Department Sample. The characteristics of the IBD-related ED visits in relation to following hospitalizations and surgeries were analyzed.<bold>Results: </bold>Adult IBD patients constitute 0.09 % of the total ED visits. Crohn's disease (CD) contributed to 69 % of the IBD-ED visits. The hospitalization rate from ED was 59.9 % nationally, ranging from 56 % in west to 69 % in northeast. The most significant factors associated with hospitalization were intra-abdominal abscess [odds ratio (OR) 24.22], bowel obstruction (OR 17.77), anemia (OR 7.54), malnutrition (OR 6.29), hypovolemia/electrolyte abnormalities (OR 5.57), and fever/abnormal white cell count (OR 3.18). Patients with CD (OR 0.66), low-income group (OR 0.90), and female gender (OR 0.87) have a lower odds of getting hospitalized. Age above 65 years (OR 1.63), CD (OR 1.89), bowel obstruction (OR 9.24), and intra-abdominal abscess (OR 18.41) were significantly associated with surgical intervention.<bold>Conclusion: </bold>The IBD-related ED visits have remained relatively stable from 2009 to 2011. The presence of anemia, malnutrition, hypovolemia, electrolyte abnormalities, fever, abnormal white cell count, bowel obstruction, or intra-abdominal abscess during the ED visit was associated with hospitalization. The presence of bowel obstruction and intra-abdominal abscess was strongly associated with surgical intervention.
- Subjects
UNITED States; INFLAMMATORY bowel disease treatment; CROHN'S disease diagnosis; MEDICAL emergencies; HOSPITAL care; CROSS-sectional method; ABDOMINAL abscess; MALNUTRITION; ANEMIA; HOSPITAL emergency services; INFLAMMATORY bowel diseases; BOWEL obstructions; POVERTY; WATER-electrolyte imbalances; ODDS ratio; DISEASE complications
- Publication
Digestive Diseases & Sciences, 2016, Vol 61, Issue 2, p389
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-015-3895-2