Mortality and morbidity outcomes in patients with inflammatory bowel disease with colon cancer: A nationwide analysis.

Abstract

e15669 Background: Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is a chronic condition characterized by inflammation of the gastrointestinal tract. Patients with IBD are at an increased risk of developing colorectal cancer due to long-term inflammation and epithelial damage. This study aims to analyze the nationwide impact of underlying colon cancer in hospitalized patients with IBD, focusing on mortality, morbidity, and healthcare utilization. Methods: We used the National Inpatient Sample Database (2016 to 2020) to find the impact of underlying colon cancer in patients admitted with inflammatory bowel disease (IBD). We used ICD-10 codes to diagnose patients with a primary diagnosis of colon cancer and a secondary diagnosis of IBD. Categorical variables were analyzed using the chi-square test, and continuous variables were analyzed using T-test. Statistical significance was set at a p-value of <0.05. Results: A total of 1123110 patients were diagnosed with a primary diagnosis of IBD. Out of them, 11231 patients had a diagnosis of colon cancer. The mean age of the patients was 60 years (p-value <0.001). Of them, females were 46%, while male patients were 54% (p-value <0.001). Most patients were white (82%), while blacks were 9% and Hispanics were 5% (p-value 0.007). The total length of stay of IBD patients with colon cancer was 7.7 days (vs 5.5 days in patients without colon cancer, aOR 2.2, p-value <0.005). The total hospital charges were also higher in IBD patients with colon cancer ($ 93661 vs $56685) (aOR 3.3, p-value 0.014). Mortality was also found to be higher in IBD patients with colon cancer (aOR 2.2, p-value <0.001). The complications were also observed to be higher in the colon cancer cohort as compared to those without colon cancer (shown in the table). Conclusions: This nationwide analysis highlights significant differences in outcomes for patients with inflammatory bowel disease (IBD) and underlying colon cancer compared to those without colon cancer. Patients with IBD and colon cancer experienced longer hospital stays, higher healthcare costs, and an increased burden of complications. Addressing these disparities could improve outcomes and reduce the economic burden associated with IBD and colon cancer. Table showing complications in patients with IBD with and without colon cancer. Outcomes IBD patients with Colon Cancer IBD patients without Colon Cancer Adjusted Odds Ratio (aOR) P-value Mortality 4.2% 1.5% 2.2 <0.001 Sepsis 8.4% 7% 1.1 0.1 Acute Kidney Injury 23% 16% 1.4 <0.001 Portal Hypertention 2% 1.9% 1.6 0.1