Changes in admissions, and hospitalization outcomes of IBD patients in an Italian tertiary referral center over a 13-year period

Franco Scaldaferri, Alfredo Papa, Eleonora Gaetani, Giovanni Cammarota, Veronica Ojetti, Francesco Franceschi, Antonio Gasbarrini, Daniele Napolitano, Gianenrico Rizzatti, Andrea Poscia, Massimo Volpe, Loris Riccardo Lopetuso, Elisa Schiavoni, Luisa Guidi, Gian Ludovico Rapaccini, Daniela Pugliese, Alessandro Armuzzi, G. Holleran

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Objective: The management of Inflammatory Bowel Disease (IBD) has changed significantly in recent years, mainly due to the introduction of biologic medications, however, other factors may also have a role. The aim of this study was to evaluate the evolution of IBD admissions, including trends, modality of admission and rates of surgical intervention, in a tertiary care center. Patients and Methods: Hospitalization of patients with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were identified between 2000 and 2013, using ICD-9-CM codes for IBD, from our hospital database. The following parameters were evaluated for each admission: type of admission (ordinary vs. day care service), mode of admission (elective vs. emergency care, for ordinary admissions only), admission code, surgical procedures and complication rates. Comparison between pre- and post-biologic therapy introduction years was also performed. Results: Between 2000 and 2013 a total of 8834 IBD-related admissions were recorded. Hospitalizations increased linearly reaching a peak in 2006, with a downward trend in the following years. The downward trend was especially marked for patients younger than 40 years. No significant differences in hospitalization trends between CD and UC were recorded. Disease flare represented the cause of hospitalization in approximately 50% of cases. Overall, 10.8% of patients underwent surgery with no difference between the two conditions. Complications occurred in 28.7% of admissions. Conclusions: Hospitalizations for IBD patients have decreased in recent years, especially in younger patients. However, a significant proportion of patients are still admitted to complete diagnostic workup, indicating the need to better implement outpatient services. A clear reduction in surgery occurrence over time could not be observed in our study.
Lingua originaleEnglish
pagine (da-a)5826-5835
Numero di pagine10
RivistaEuropean Review for Medical and Pharmacological Sciences
Volume25
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Biologic therapy
  • Healthcare organization
  • Hospitalizations
  • Inflammatory bowel disease

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