P0777 - Spondyloarthropathy in Inflammatory Bowel Disease - An Epidemiological, Outcome, and Healthcare Utilization Analysis of the National Inpatient Sample Database

Tushar Khanna, MD, Preeti Misra, MD, David Steinberger, MD
Trinity Health Livonia, Livonia, MI

Introduction: Spondyloarthropathy(SpA) is a known extraintestinal manifestation of Inflammatory Bowel Disease (IBD) with several subtypes.There is a limited understanding of the outcomes & healthcare utilization of concomitant SpA in hospitalized IBD patients. We investigated the National Inpatient Sample (NIS) database to determine demographics, epidemiology, resource utilization & outcomes of hospitalized IBD patients with SpA.

Methods: We analyzed weighted NIS data for all adults hospitalized with IBD as a primary, secondary & tertiary discharge diagnosis & subtypes of SpA as among the remaining discharge diagnosis using validated ICD-9 & 10 codes between 2010-19.Descriptive statistics & regression analysis were used to analyze patient characteristics,comorbidities,LOS,hospital charges & mortality.

Results: From 2010 and 2019 there were 2,156,158 weighted discharges of patients with IBD of which 33,921(1.57%)had concomitant SpA. Hospitalized IBD patients with SpA were older;more male & white;living in higher income quartile zip codes; on Medicare and discharged from larger hospitals. While there were higher rates of colectomy (12.55% vs 11.08%, P< 0.001)in IBD patients with SpA; there were lower rates of intestinal perforation (0.48% vs 0.71%, P< 0.04), intestinal obstruction (13.14% vs 15.39%, p< 0.0001); & peritonitis in this group.Patients with IBD and SpA tended to have significantly increased incidence of autoimmune conditions such as psoriasis, Reiter’s and giant cell arteritis compared to those without SpA. Patients with IBD and concomitant spA appear to have increased risk of major/extreme risk of disease severity but only a minor or moderate risk of mortality based on the APRDRG mortality and severity scores. SpA in IBD patients appears to lead to a higher cost per hospitalization, 30,527$ vs 25,320%, p< 0.001, although no difference in length of stay was observed in both groups.

Discussion: Hospitalized IBD patients with SpA tend to have a higher rates of colectomy & increased incidence of autoimmune conditions but lower rates of intestinal obstruction & perforation as well as are associated with a minor to moderate risk of mortality compared to those without SpA.These patients have higher hospitalization costs but no difference in length of stay.IBD patients with SpA are known to have a distinct genetic & microbial signature that may possibly explain these differences in outcomes although further research is needed to understand the causal mechanisms & therefore improve management.



Disclosures:


Tushar Khanna, MD, Preeti Misra, MD, David Steinberger, MD. P0777 - Spondyloarthropathy in Inflammatory Bowel Disease - An Epidemiological, Outcome, and Healthcare Utilization Analysis of the National Inpatient Sample Database, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.