P2134 - Impact of Neutropenia on Outcomes in Patients with Ulcerative Colitis: A Retrospective Analysis from Nationwide In-Patient Sample

Monday, October 23, 2023

10:30 AM – 4:15 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

Oluwanifemi Balogun, MD

Albert Einstein Medical Center
Philadelphia, PA

Oluwanifemi Balogun, MD¹, Abiodun Idowu, MD¹, Blanche B. Echikunwoke, MD¹, Oyedotun Babajide, MBBS², Elizabeth Soladoye, MD, MPH³, Ayobami Olafimihan, MD⁴, Jordan Carty, MD¹, Kevin Robinson, MD¹, James Walter, MD⁵
¹Albert Einstein Medical Center, Philadelphia, PA; ²One Brooklyn Health, Brooklyn, NY; ³Piedmont Athens Regional, Athens, GA; ⁴John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ⁵Einstein Healthcare Network, Philadelphia, PA

Introduction: Cytopenia is a common adverse effect of medications used in the management of inflammatory bowel diseases. Patients with neutropenia, a common cytopenia, have an increased risk of disease progression and at high risk of untoward patient outcome in most chronic medical conditions. There are, however, limited studies that have evaluated the impact of neutropenia on ulcerative colitis (UC). This study aims to bridge that knowledge gap by using real world contemporary data.

Methods: In this retrospective analysis, we examined patients admitted in the US between 2018 and 2020. We utilized the national inpatient sample database using the international classification of disease tenth edition (ICD-10) codes to identify patients > 18 years admitted with primary diagnosis of UC. A multivariate logistic regression model that adjusted for established cofounders was created to determine the relationship between neutropenia and outcomes of interest. All analyses were conducted at a significance level of 5% (p < 0.05) with a 95% confidence interval (CI)

Results: A total of 293,840 patients were admitted on a non-elective basis for UC from 2018 to 2020. Of these, 2,060 patients had neutropenia. Patients with UC with neutropenia are at increased risk of complications: abscess formation (aOR 1.77, 95% CI 1.01-3.09, p = 0.044), 3-times risk of sepsis (20.2% vs 7.9%, aOR 3.12, 95% CI 2.43-4.00, p< 0.001), 2-fold risk of anemia (30.2% vs 45.6%, aOR 2.01, 95% CI 1.64-2.46, p< 0.001), 2-fold risk of malnutrition (aOR 2.18, 95% CI 1.71-2.77, p < 0.001), and 2.91 times prone to needing total parenteral nutrition (aOR 2.91, 95% 1.75-4.84, p< 0.001). Similarly, all-cause in-hospital mortality rate is 4-fold (8.5% vs 2.5%, aOR 3.98, 95% CI 2.82-5.61, p< 0.001) higher in patients with UC and neutropenia. There was no statistically significant difference in the ages of patients with UC with and without neutropenia (p > 0.05

Discussion: Neutropenia in patients with ulcerative colitis is linked to elevated complications (anemia, abscess formation, malnutrition, clostridium difficile infection, acute kidney injury, large bowel resection, parenteral nutrition, sepsis) and a higher all-cause in-patient mortality, indicating its potential prognostic significance in this patient population.

	Neutropenia		aOR	95% CI	p-value
	No	Yes	aOR	95% CI	p-value
Anemia	30.2%	45.6%	2.01	1.64-2.46	< 0.001
Abscess	1.8%	3.2%	1.77	1.01-3.09	0.044
Malnutrition	13.8%	25.7%	2.18	1.71-2.77	< 0.001
Clostridium difficile	3.9%	7.5%	2.04	1.43-2.92	< 0.001
Acute Kidney Injury	18.4%	24.8%	1.64	1.28-2.09	< 0.001
Large bowel resection	1.6%	2.4%	1.50	0.80-2.81	0.209
Total Parenteral Nutrition	1.4%	4.1%	2.91	1.75-4.84	< 0.001
Sepsis	7.9%	20.2%	3.12	2.43-4.00	< 0.001
Death	2.5%	8.5%	3.98	2.82-5.61	< 0.001

Disclosures:

Oluwanifemi Balogun indicated no relevant financial relationships.

Abiodun Idowu indicated no relevant financial relationships.

Blanche Echikunwoke indicated no relevant financial relationships.

Oyedotun Babajide indicated no relevant financial relationships.

Elizabeth Soladoye indicated no relevant financial relationships.

Ayobami Olafimihan indicated no relevant financial relationships.

Jordan Carty indicated no relevant financial relationships.

Kevin Robinson indicated no relevant financial relationships.

James Walter: Eli Lilly – Advisor or Review Panel Member. Medtronic – Consultant.

Oluwanifemi Balogun, MD¹, Abiodun Idowu, MD¹, Blanche B. Echikunwoke, MD¹, Oyedotun Babajide, MBBS², Elizabeth Soladoye, MD, MPH³, Ayobami Olafimihan, MD⁴, Jordan Carty, MD¹, Kevin Robinson, MD¹, James Walter, MD⁵. P2134 - Impact of Neutropenia on Outcomes in Patients with Ulcerative Colitis: A Retrospective Analysis from Nationwide In-Patient Sample, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.