OBJECTIVES:

To compare trends in hospital length of stay, total costs and comorbidities in patients with Ulcerative Colitis (UC) and Crohn’s Disease (CD) patients with and without surgery.

METHODS: The 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for UC and CD patients with and without surgery. Propensity score matched analysis was conducted to compare hospital LOS and costs in selected patients. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 331950 hospitalizations with a diagnosis code of UC or CD, of which approximately 21% had a procedure code for gastrointestinal surgery (excision, repair, resection or bypass). The UC/CD patients who underwent surgery were younger than those who did not have surgery (46.32 [SD 19.94] and 53.02 [SD 19.9] years, respectively). Approximately 53% and 57% of UC/CD with or without surgery were female, respectively. Majority of patients in no surgery group were covered by Medicare (43%), while surgery group was covered by Private insurance (46%). The hospital length of stay was significantly longer in the UC/CD with surgery group versus no surgery group (7.79 [SD 9.64] versus 4.79 [SD 5.78] years). Similarly, the mean hospital charges were significantly higher in the surgery versus no surgery group ($78550 vs $45128). The comorbidities that differed in two groups were: Weight loss (20% vs 11%), Hypertension (25% vs 33%), Renal Failure (7% vs 13%) and Depression (15% vs 19%), in surgery vs no surgery groups, respectively.

CONCLUSIONS: Ulcerative Colitis (UC) and Crohns Disease (CD) patients with or without surgery pose significant burden of hospitalizations on the healthcare system. There is need for better managements of UC/CD patients.