IBD Accounts for Significant Unplanned Health Care Utilization

A systematic review with meta-analysis concluded that population health management strategies are needed to reduce the prevalence of hospitalization seen among patients with inflammatory bowel disease (IBD).

The investigators examined population-based cohort studies of patients with IBD to estimate the incidence of hospitalizations related directly to ulcerative colitis (UC) or Crohn disease (CD). Their review identified cohort studies of patients with UC and CD, reporting the cumulative incidence of hospitalization at 1, 3, and 5 years post-diagnosis.

Among 6 cohorts of patients with UC, the researchers found that the 1-, 3- and 5-year risk of hospitalization related to IBD was 10.4% (95% CI 8.2–13.2), 17.0% (95% CI 14.0–20.4), and 21.5% (95% CI 18.0–25.4), respectively. In 6 cohorts of patients with CD, the 1-, 3- and 5-year risk of IBD-related hospitalization was 29.3% (95% CI 20.0–40.8), 38.5% (95% CI 26.8–51.7), and 44.3% (95% CI 32.7–56.5), respectively.

“On meta-regression, steady decline in risk of hospitalization was observed in patients diagnosed in a more contemporary era,” the authors noted. “Younger age at onset (both UC and CD), extensive colitis (UC), ileal-dominant CD, perianal CD and penetrating and/or stricturing behavior (CD) and early need for corticosteroids and immunosuppressive therapy (both UC and CD) were associated with increased risk of hospitalization.”

With approximately 1 in 5 patients with UC and 1 in 2 patients with CD requiring hospitalization within 5 years of diagnosis, the authors suggest, “Population health management strategies are required to mitigate unplanned healthcare utilization.”

—Rebecca Mashaw

Tsai L, Nguyen NH, Ma C, Prokop LJ, Sandborn WJ, Singh S. Systematic review and meta-analysis: risk of hospitalization in patients with ulcerative colitis and Crohn’s disease in population-based cohort studies. Digestive Diseases and Sciences. Published online August 11, 2021. https://doi.org/10.1007/s10620-021-07200-1