13-year mortality trends among hospitalized patients with inflammatory bowel disease
<p>Abstract</p> <p>Background</p> <p>Studies 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 det...
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| Format: | Article |
| Language: | English |
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BMC
2012-06-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-230X/12/79 |
| _version_ | 1818351720569241600 |
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| author | Sewell Justin L Yee Hal F |
| author_facet | Sewell Justin L Yee Hal F |
| author_sort | Sewell Justin L |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Studies 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.</p> <p>Methods</p> <p>We 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.</p> <p>Results</p> <p>150 (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 (<it>P</it> = 0.012). Subject age (OR 1.06 per year, <it>P</it> < 0.001), Charlson comorbidity index (OR 1.29 per 1-point increase, <it>P</it> < 0.001), and diagnosis of ulcerative colitis (versus Crohn’s disease, OR 1.41, <it>P</it> = .042) were also associated with in-hospital mortality.</p> <p>Conclusions</p> <p>The 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.</p> |
| first_indexed | 2024-12-13T18:42:14Z |
| format | Article |
| id | doaj.art-5fdcf01d3e9f4890b2621b9de1ee413a |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-13T18:42:14Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-5fdcf01d3e9f4890b2621b9de1ee413a2022-12-21T23:35:11ZengBMCBMC Gastroenterology1471-230X2012-06-011217910.1186/1471-230X-12-7913-year mortality trends among hospitalized patients with inflammatory bowel diseaseSewell Justin LYee Hal F<p>Abstract</p> <p>Background</p> <p>Studies 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.</p> <p>Methods</p> <p>We 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.</p> <p>Results</p> <p>150 (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 (<it>P</it> = 0.012). Subject age (OR 1.06 per year, <it>P</it> < 0.001), Charlson comorbidity index (OR 1.29 per 1-point increase, <it>P</it> < 0.001), and diagnosis of ulcerative colitis (versus Crohn’s disease, OR 1.41, <it>P</it> = .042) were also associated with in-hospital mortality.</p> <p>Conclusions</p> <p>The 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.</p>http://www.biomedcentral.com/1471-230X/12/79Inflammatory bowel diseaseCrohn’s diseaseUlcerative colitisHospitalizationEpidemiologyMortalityIn-hospital mortalityOutcomes |
| spellingShingle | Sewell Justin L Yee Hal F 13-year mortality trends among hospitalized patients with inflammatory bowel disease BMC Gastroenterology Inflammatory bowel disease Crohn’s disease Ulcerative colitis Hospitalization Epidemiology Mortality In-hospital mortality Outcomes |
| title | 13-year mortality trends among hospitalized patients with inflammatory bowel disease |
| title_full | 13-year mortality trends among hospitalized patients with inflammatory bowel disease |
| title_fullStr | 13-year mortality trends among hospitalized patients with inflammatory bowel disease |
| title_full_unstemmed | 13-year mortality trends among hospitalized patients with inflammatory bowel disease |
| title_short | 13-year mortality trends among hospitalized patients with inflammatory bowel disease |
| title_sort | 13 year mortality trends among hospitalized patients with inflammatory bowel disease |
| topic | Inflammatory bowel disease Crohn’s disease Ulcerative colitis Hospitalization Epidemiology Mortality In-hospital mortality Outcomes |
| url | http://www.biomedcentral.com/1471-230X/12/79 |
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