13-year mortality trends among hospitalized patients with inflammatory bowel disease Full Text
BMC Gastroenterology, 07/16/2012
Clinical Article
Sewell JL et al. – 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.
Methods- The authors 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.
- 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 (P=0.012).
- Subject age (OR 1.06 per year, P<0.001), Charlson comorbidity index (OR 1.29 per 1-point increase, P<0.001), and diagnosis of ulcerative colitis (versus Crohn's disease, OR 1.41, P=.042) were also associated with in-hospital mortality.
