Comparison of Characteristics and Inpatient Outcomes of Patients With Inflammatory Bowel Disease and Colon Cancer: A Propensity-Based Nationwide Inpatient Sample Study

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2022 Jan 10

PMID 35004009

Authors

Prashant Subedi

Mukesh S Paudel

Vijay Gayam

Amrendra Mandal

Affiliations

Soon will be listed here.

Abstract

Introduction Patients with inflammatory bowel diseases (IBDs) frequently develop colon cancer. Previous studies have identified the association between IBD and colon cancer. In this study, we explored the characteristics and outcomes of IBD patients with colon cancer admitted to the hospitals of the United States. Methods Patients who were hospitalized patients with diagnoses of IBD and colon cancer were compared with patients with IBD without colon cancer. The data were extracted from the Nationwide Inpatient Sample (NIS) from January 2016 to December 2017. Comparisons were made with regards to mortality, complications, in-hospital stay, and cost of treatment between the two groups. Results We identified 1,82,025 hospitalizations from January 2016 to December 2017 admitted with a diagnosis of IBD. Of these, 181,560 patients had IBD without colon cancer, and 465 patients had IBD with colon cancer. No statistically significant difference was observed with regards to the in-hospital mortality between the two groups. There were higher odds of acute kidney injury (AKI) (OR 1.54, 95% CI 6.6-9.8; p=0.00), colectomy (OR 1.2, 95% CI 1.3-2.5; p=0.0) and lower gastrointestinal bleeding (LGIB) (OR 1.6, 95% CI 1.8-3.7; p=0.04) in patients with IBD and colon cancer. A longer length of stay (7.1±6.9 vs.5.0±5.6, p=0.00) and higher mean total charge ($20,283 vs. $12,166, p=0.00) were observed in patients with IBD with colon cancer. Conclusions Patients with IBD-associated colon cancer appear to have higher complication rates, higher costs, and more extended hospital stays. Therefore, early identification and management of complications related to IBD among patients with colon cancer are particularly crucial to reduce morbidity as well as the cost of hospitalization and treatment.

References

Gisbert J, Chaparro M . Predictors of Primary Response to Biologic Treatment [Anti-TNF, Vedolizumab, and Ustekinumab] in Patients With Inflammatory Bowel Disease: From Basic Science to Clinical Practice. J Crohns Colitis. 2019; 14(5):694-709. DOI: 10.1093/ecco-jcc/jjz195. View

Cosnes J, Gower-Rousseau C, Seksik P, Cortot A . Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011; 140(6):1785-94. DOI: 10.1053/j.gastro.2011.01.055. View

Ananthakrishnan A . Epidemiology and risk factors for IBD. Nat Rev Gastroenterol Hepatol. 2015; 12(4):205-17. DOI: 10.1038/nrgastro.2015.34. View

DAgostino Jr R . Propensity scores in cardiovascular research. Circulation. 2007; 115(17):2340-3. DOI: 10.1161/CIRCULATIONAHA.105.594952. View

Eaden J, Abrams K, Mayberry J . The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut. 2001; 48(4):526-35. PMC: 1728259. DOI: 10.1136/gut.48.4.526. View

Munkholm P . Review article: the incidence and prevalence of colorectal cancer in inflammatory bowel disease. Aliment Pharmacol Ther. 2003; 18 Suppl 2:1-5. DOI: 10.1046/j.1365-2036.18.s2.2.x. View

Ullman T, Itzkowitz S . Intestinal inflammation and cancer. Gastroenterology. 2011; 140(6):1807-16. DOI: 10.1053/j.gastro.2011.01.057. View

Itzkowitz S, Present D . Consensus conference: Colorectal cancer screening and surveillance in inflammatory bowel disease. Inflamm Bowel Dis. 2005; 11(3):314-21. DOI: 10.1097/01.mib.0000160811.76729.d5. View

Navaneethan U, Zhu X, Lourdusamy D, Lourdusamy V, Shen B, Kiran R . Colorectal cancer resection rates in patients with inflammatory bowel disease: a population-based study. Gastroenterol Rep (Oxf). 2018; 6(4):263-269. PMC: 6225820. DOI: 10.1093/gastro/goy030. View

10.

Jess T, Simonsen J, Jorgensen K, Pedersen B, Nielsen N, Frisch M . Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology. 2012; 143(2):375-81.e1. DOI: 10.1053/j.gastro.2012.04.016. View

11.

Molodecky N, Soon I, Rabi D, Ghali W, Ferris M, Chernoff G . Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2011; 142(1):46-54.e42. DOI: 10.1053/j.gastro.2011.10.001. View

12.

Khera R, Angraal S, Couch T, Welsh J, Nallamothu B, Girotra S . Adherence to Methodological Standards in Research Using the National Inpatient Sample. JAMA. 2017; 318(20):2011-2018. PMC: 5742631. DOI: 10.1001/jama.2017.17653. View

13.

Watanabe T, Konishi T, Kishimoto J, Kotake K, Muto T, Sugihara K . Ulcerative colitis-associated colorectal cancer shows a poorer survival than sporadic colorectal cancer: a nationwide Japanese study. Inflamm Bowel Dis. 2010; 17(3):802-8. DOI: 10.1002/ibd.21365. View

14.

Rutter M, Saunders B, Wilkinson K, Rumbles S, Schofield G, Kamm M . Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology. 2004; 126(2):451-9. DOI: 10.1053/j.gastro.2003.11.010. View

15.

Smyth C, Picha S, Rathore O, Deasy J, Patchett S, Murray F . Increasing rates and changing patterns of hospital admissions for patients with inflammatory bowel disease in Ireland: 1996-2001. Ir J Med Sci. 2006; 174(4):28-32. DOI: 10.1007/BF03168978. View

16.

Whelan G . Epidemiology of inflammatory bowel disease. Med Clin North Am. 1990; 74(1):1-12. DOI: 10.1016/s0025-7125(16)30581-8. View

17.

Ording A, Horvath-Puho E, Erichsen R, Long M, Baron J, Lash T . Five-year mortality in colorectal cancer patients with ulcerative colitis or Crohn's disease: a nationwide population-based cohort study. Inflamm Bowel Dis. 2013; 19(4):800-5. DOI: 10.1097/MIB.0b013e3182802af7. View

18.

Austin P . An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. Multivariate Behav Res. 2011; 46(3):399-424. PMC: 3144483. DOI: 10.1080/00273171.2011.568786. View

19.

Steiner C, Elixhauser A, Schnaier J . The healthcare cost and utilization project: an overview. Eff Clin Pract. 2002; 5(3):143-51. View