NAFLD Linked to Worse Clinical Outcomes in Hospitalized Crohn’s Disease Patients
A new analysis of national inpatient data published in Inflammatory Bowel Diseases reveals that patients with Crohn’s disease (CD) and comorbid nonalcoholic fatty liver disease (NAFLD) experience significantly worse clinical outcomes and higher resource utilization compared to those without NAFLD.
Using data from the National Inpatient Sample (NIS) from 2017 to 2020, the study examined 792,409 hospitalizations for CD, of which 26,229 (3.3%) involved patients with coexisting NAFLD. The primary outcome was inpatient mortality, with secondary endpoints including cardiogenic shock, gastrointestinal bleeding (GIB), intubation, length of stay, and total hospital charges.
The findings indicate that patients with CD and NAFLD were older (mean age 57.80 vs 52.50 years, P<0.05), more likely to be male (46.17% vs 42.10%, P<0.05), and more often identified as Caucasian (82.42% vs 77.10%, P<0.05). These patients had a higher burden of comorbidities, including heart failure (16.47% vs 10.00%, P<0.05), pulmonary hypertension (4.00% vs 2.00%), and acute kidney injury (33.60% vs 16.10%, P<0.05). Obesity and anemia were also more prevalent in the NAFLD group.
Critically, the study found a clear link between NAFLD and major adverse cardiovascular events (MACE) such as acute coronary syndrome (4.50% vs 2.60%, P<0.05), along with increased risks of gastrointestinal bleeding and the need for intensive care. "NAFLD is associated with greater risk for MACE, GIB, and ICU care," the authors stated.
Despite similar rates of dyslipidemia and stroke between groups, patients with CD and NAFLD demonstrated higher inpatient mortality and required more intensive medical intervention. The study concluded that “NAFLD is an important risk factor among patients with CD that predicts adverse outcomes.”
These findings underscore the need for heightened clinical vigilance and risk stratification for patients with CD and NAFLD. Gastroenterologists may consider more proactive monitoring and multidisciplinary care for this high-risk subgroup to mitigate complications and improve outcomes.
Reference
Rahima K, Albuni MK, Hijazi M, Ikpeze T, Bitar B, Muddana V. Patients with crohn’s disease affected by non-alcoholic fatty liver disease have a greater risk of mortality and worse clinical outcomes. Inflammatory Bowel Diseases. 2024;30(Supplement_1):S35. doi:10.1093/ibd/izae020.075
