Rising hospitalization rates for inflammatory bowel disease in the United States between 1998 and 2004

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Original Article

Rising hospitalization rates for inflammatory bowel disease in the United States between 1998 and 2004

Geoffrey C. Nguyen, MD, PhD 1 2 *, Anne Tuskey, MD 2, Themistocles Dassopoulos, MD 2, L. , MD 2, R. Brant, MD 1 2

1Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, s Hopkins University School of Medicine, Baltimore, land2Mount Sinai Hospital IBD Centre, University of Toronto School of Medicine, Toronto, Ontario, Canada

*Correspondence to Geoffrey C. Nguyen, 600 University Ave., Rm. 441, Toronto, ON M5G 1X5These findings were presented as a poster at Digestive Disease Week 2007.

Funded by: Ruth L. Kirschstein individual postdoctoral fellowship National Institutes of Health; Grant Number: F32DK076257 Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center

Keywords

Crohn's disease • general clinical • economics of IBD therapies • epidemiology • outcomes research/measurements • surgery for IBD • ulcerative colitis

Abstract

Background: Recent epidemiological studies suggest that the prevalences of Crohn's disease (CD) and ulcerative colitis (UC) are increasing in the United States. We sought to determine whether nationwide rates of inflammatory bowel disease (IBD) hospitalizations have increased in response to temporal trends in prevalence.

Methods: We identified all admissions with a primary diagnosis of CD or UC, or 1 of their complications in the Nationwide Inpatient Sample between 1998 and 2004. National estimates of hospitalization rates and rates of surgery were determined using the U.S. Census population as the denominator.

Results: There were an estimated 359,124 and 214,498 admissions for CD and UC, respectively. The overall hospitalization rate for CD was 18.0 per 100,000 and that for UC was 10.8 per 100,000. There was a 4.3% annual relative increase in hospitalization rate for CD (P < 0.0001) and a 3.0% annual increase for UC (P < 0.0001). Surgery rates were 3.4 bowel resections per 100,000 for CD and 1.2 colectomies per 100,000 for UC and remained stable. There were no temporal patterns for average length of stay for CD (5.8 days) or for UC (6.8 days). The national estimate of total inpatient charges attributable to CD increased from $762 million to $1,330 million between 1998 and 2004, and that for UC increased from $592 million to $945 million.

Conclusions: Hospitalization rates for IBD, particularly CD, have increased within a 7-year period, incurring a substantial rise in inflation-adjusted economic burden. The findings reinforce the need for effective treatment strategies to reduce IBD complications.

(Inflamm Bowel Dis 2007)

Digital Object Identifier (DOI)10.1002/ibd.20250 About DOI