Trends in hospital admissions and mortality among inflammatory bowel disease patients with substance use disorder: a 10-year United States nationwide analysis

Karina Fatakhova; Pratik Patel; Faisal Inayat; Rubaid Dhillon; Hassam Ali; Sobaan Taj; Gul Nawaz; Arslan Afzal; Attiq Ur Rehman; Muhammad Sohaib Afzal; Rafeh Khan; Rizwan Ishtiaq; Lindsey Jones; Ramona Rajapakse

doi:10.1080/08998280.2023.2204535

Trends in hospital admissions and mortality among inflammatory bowel disease patients with substance use disorder: a 10-year United States nationwide analysis

Proc (Bayl Univ Med Cent). 2023 May 3;36(4):427-433. doi: 10.1080/08998280.2023.2204535. eCollection 2023.

Authors

Affiliations

¹ Department of Gastroenterology, Mather Hospital and Hofstra University Zucker School of Medicine, Port Jefferson, New York.
² Department of Medicine, Allama Iqbal Medical College, Lahore, Punjab, Pakistan.
³ Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio.
⁴ Department of Internal Medicine, East Carolina University Brody School of Medicine, Greenville, North Carolina.
⁵ Department of Internal Medicine, Hackensack Meridian Jersey Shore University Medical Center, Neptune, New Jersey.
⁶ Department of Internal Medicine, Marshfield Clinic Health System, Marshfield, Wisconsin.
⁷ Department of Internal Medicine, Woodhull Medical Center, Brooklyn, New York.
⁸ Department of Hepatology, Mercy Medical Center, Baltimore, Maryland.
⁹ Department of Medicine, Louisiana State University Health, Shreveport, Louisiana.
¹⁰ Department of Internal Medicine, Quaid-e-Azam Medical College, Bahawalpur, Punjab, Pakistan.
¹¹ Department of Internal Medicine, Saint Francis Hospital and Medical Center, Hartford, Connecticut.
¹² Department of Internal Medicine, Mather Hospital and Hofstra University Zucker School of Medicine, Port Jefferson, New York.

Abstract

Background: Patients with inflammatory bowel disease (IBD) and substance use disorder (SUD) may have worse clinical outcomes. However, data specific to the hospital admission and mortality rates among IBD patients with SUD are scarce. Our objective was to assess trends in admission, healthcare expenses, and mortality for IBD patients with SUD.

Methods: We conducted a retrospective study using the National Inpatient Sample database to analyze SUD (alcohol, opioids, cocaine, and cannabis) among IBD hospitalizations from 2009 to 2019.

Results: A total of 132,894 hospitalizations for IBD had a secondary diagnosis of SUD. Of these patients, 75,172 (57%) were men and 57,696 (43%) were women. The IBD-SUD cohort had a longer length of stay than the non-SUD cohort (P < 0.001). The mean inpatient charges for IBD hospitalizations with SUD increased from $48,699 ± $1374 in 2009 to $62,672 ± $1528 in 2019 (P < 0.001). We found a 159.5% increase in IBD hospitalizations with SUD. The hospitalization rate increased from 3492 per 100,000 IBD hospitalizations in 2009 to 9063 per 100,000 in 2019 (P < 0.001). In-hospital mortality for IBD hospitalizations with SUD increased by 129.6% (from 250 deaths per 100,000 IBD hospitalizations in 2009 to 574 deaths per 100,000 IBD hospitalizations in 2019) (P < 0.001).

Conclusions: Over the last decade, there has been a rise in IBD hospitalizations with SUD. This has resulted in a longer length of stay, higher inpatient charges, and higher mortality rates. Identifying IBD patients potentially at risk for SUD by screening for anxiety, depression, pain, or other factors has become crucial.

Keywords: Alcoholism; hospital admission; human risk factors; inflammatory bowel disease; mortality rate; substance use disorder.