Bivariate analysis of primary diagnosis of IBD with and without a secondary diagnosis of SIs in the national inpatient database from 2009 to 2019
Variables
No SIs
SIs
P-value
Total number of hospitalizations
829,157 (99.77%)
1,724 (0.23%)
Mean age, years ± SE
45.26 ± 0.84
41.47 ± 0.25
P < 0.001
Mean LOS, days ± SE
5.30 ± 0.09
7.78 ± 0.50
P < 0.001
Mean hospitalization charges, USD ± SE
41,667 ± 669
55,482 ± 256
P = 0.0011
Age group (years)
18–34
271,062 (34.6%)
671 (38.9%)
P < 0.001
35–49
211,178 (27.0%)
540 (31.3%)
50–64
166,072 (21.2%)
404 (23.4%)
65–79
99,130 (12.7%)
69 (4.0%)
≥ 80
35,935 (4.6%)
40 (2.3%)
Gender
Male
384,009 (46.3%)
928 (53.8%)
P = 0.0057
Female
444,542 (53.7%)
796 (46.2%)
Race
White
566,635 (73.3%)
1,183 (74.2%)
P = 0.15
Black
105,332 (13.6%)
253 (15.9%)
Hispanic
63,450 (8.2%)
105 (6.6%)
Asian
11,476 (1.5%)
4 (0.3%)
Native American
3,122 (0.4%)
16 (1.0%)
Other
22,617 (2.9%)
34 (2.1%)
CCI score
0
67,327 (8.1%)
95 (5.6%)
P = 0.006
1
229,013 (27.7%)
348 (20.3%)
2
530,210 (64.1%)
1,268 (74.1%)
≥ 3
46,083 (5.6%)
154 (8.9%)
Hospital region
Northeast
195,521 (24.7%)
463 (28.3%)
P = 0.0001
Midwest
141,114 (17.8%)
578 (35.4%)
South
399,249 (50.5%)
411 (25.2%)
West
55,300 (7.0%)
182 (11.1%)
Hospital location and teaching status
Rural
67,327 (8.1%)
95 (5.6%)
P = 0.0001
Urban nonteaching
229,013 (27.7%)
348 (20.3%)
Urban teaching
530,210 (64.1%)
1,268 (74.1%)
Expected primary payer
Medicare
195,521 (24.7%)
463 (28.3%)
P < 0.001
Medicaid
141,114 (17.8%)
578 (35.4%)
Private
399,249 (50.5%)
411 (25.2%)
Other
55,300 (7.0%)
182 (11.1%)
Median household income (quartile)
1st
203,291 (25.0%)
472 (28.1%)
P = 0.097
2nd
205,044 (25.2%)
471 (28.0%)
3rd
207,672 (25.5%)
429 (25.5%)
4th
198,512 (24.4%)
310 (18.4%)
Inpatient mortality
3,027 (0.4%)
10 (0.6%)
P = 0.55
GAD
6,789 (0.8%)
84 (4.9%)
P < 0.001
Depression
93,891 (11.3%)
728 (42.2%)
P < 0.001
Chronic steroid use
66,332 (8%)
121 (7%)
P = 0.47
Major abdominal surgeries
107,790 (13%)
155 (9%)
P = 0.06
The median household income was divided into 4 parts equally, the 1st through the 4th represents the 0–25th, 26th–50th, 51st–75th, and 76th–100th respectively. USD: United States dollar
Yu Q, Zhu C, Feng S, Xu L, Hu S, Chen H, et al. Economic burden and health care access for patients with inflammatory bowel diseases in China: web-based survey study. J Med Internet Res. 2021;23:e20629. [DOI] [PubMed] [PMC]
Neuendorf R, Harding A, Stello N, Hanes D, Wahbeh H.Depression and anxiety in patients with inflammatory bowel disease: a systematic review. J Psychosom Res. 2016;87:70–80. [DOI] [PubMed]
Marrie RA, Walld R, Bolton JM, Sareen J, Walker JR, Patten SB et al.; CIHR Team in Defining the Burden and Managing the Effects of Psychiatric Comorbidity in Chronic Immunoinflammatory Disease. Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease. Epidemiol Psychiatr Sci. 2019;28:333–42. [DOI] [PubMed] [PMC]
Sanchez LE, Le LT.Suicide in mood disorders. Depress. Anxiety. 2001;14:177–82. [DOI] [PubMed]
Lewis K, Marrie RA, Bernstein CN, Graff LA, Patten SB, Sareen J, et al.; CIHR Team in Defining the Burden and Managing the Effects of Immune-Mediated Inflammatory Disease. The prevalence and risk factors of undiagnosed depression and anxiety disorders among patients with inflammatory bowel disease. Inflamm Bowel Dis. 2019;25:1674–80. [DOI] [PubMed]
Marafini I, Longo L, Lavasani DM, Rossi R, Salvatori S, Pianigiani F, et al. High frequency of undiagnosed psychiatric disorders in inflammatory bowel diseases. J Clin Med. 2020;9:1387. [DOI] [PubMed] [PMC]
Ludvigsson JF, Olén O, Larsson H, Halfvarson J, Almqvist C, Lichtenstein P, et al. Association between inflammatory bowel disease and psychiatric morbidity and suicide: a Swedish nationwide population-based cohort study with sibling comparisons. J Crohns Colitis. 2021;15:1824–36. [DOI] [PubMed] [PMC]
Xiong Q, Tang F, Li Y, Xie F, Yuan L, Yao C, et al. Association of inflammatory bowel disease with suicidal ideation, suicide attempts, and suicide: a systematic review and meta-analysis. J Psychosom Res. 2022;160:110983. [DOI] [PubMed]
Nguyen GC, LaVeist TA, Harris ML, Wang MH, Datta LW, Brant SR.Racial disparities in utilization of specialist care and medications in inflammatory bowel disease. Am J Gastroenterol. 2010;105:2202–8. [DOI] [PubMed] [PMC]
Dos Santos Marques IC, Theiss LM, Wood LN, Gunnells DJ, Hollis RH, Hardiman KM, et al. Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease. Am J Surg. 2021;221:668–74. [DOI] [PubMed]
Park KT, Ehrlich OG, Allen JI, Meadows P, Szigethy EM, Henrichsen K, et al. The cost of inflammatory bowel disease: an initiative from the Crohn’s & Colitis foundation. Inflamm Bowel Dis. 2020;26:1–10. Erratum in: Inflamm Bowel Dis. 2020;26:1118. [DOI] [PubMed] [PMC]
McGuire TG, Miranda J.New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Aff (Millwood). 2008;27:393–403. [DOI] [PubMed] [PMC]
Miranda J, McGuire TG, Williams DR, Wang P.Mental health in the context of health disparities. Am J Psychiatry. 2008;165:1102–8. [DOI] [PubMed]
Khera R, Angraal S, Couch T, Welsh JW, Nallamothu BK, Girotra S, et al. Adherence to methodological standards in research using the national inpatient sample. JAMA. 2017;318:2011–18. [DOI] [PubMed] [PMC]
Solanki S, Haq KF, Chakinala RC, Khan Z, Aronow WS, Ali Khan M, et al. Inpatient burden of esophageal varices in the United States: analysis of trends in demographics, cost of care, and outcomes. Ann Transl Med. 2019;7:480. [DOI] [PubMed] [PMC]
Ali H, Pamarthy R, Bolick NL, Farooq MF.Ten-year trends and prediction model of 30-day inpatient mortality for alcoholic hepatitis in the United States. Ann Gastroenterol. 2022;35:427–33. [DOI] [PubMed] [PMC]
Ali H, Pamarthy R, Bolick NL, Lambert K, Naseer M.Relation between inflammatory bowel disease, depression, and inpatient outcomes in the United States. Proc (Bayl Univ Med Cent). 2022;35:278–83. [DOI] [PubMed] [PMC]
Patel SD, Desai N, Rane S, Patel N, Desai R, Mehta T, et al. Trends in hospitalizations and epidemiological characteristics of adults moyamoya disorder in the United States. J Neurol Sci. 2020;419:117165. [DOI] [PubMed]
Martín N, Li Y.Multiple comparison of change trends in cancer mortality/incidence rates taking with overlapping regions and time-periods. In: Pardo L, Balakrishnan N, Gil MÁ, editors. Modern mathematical tools and techniques in capturing complexity. Berlin, Heidelberg: Springer Berlin Heidelberg; 2011. pp. 485–94. [DOI]
Villarreal-Zegarra D, Cabrera-Alva M, Carrillo-Larco RM, Bernabe-Ortiz A.Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study. BMJ Open. 2020;10:e036777. [DOI] [PubMed] [PMC]
Clayton DG, Michael H.Statistical models in epidemiology. Oxford: Oxford University Press; 2013.
Han B, Crosby AE, Ortega LA, Parks SE, Compton WM, Gfroerer J.Suicidal ideation, suicide attempt, and occupations among employed adults aged 18–64 years in the United States. Compr Psychiatry. 2016;66:176–86. [DOI] [PubMed] [PMC]
Goodwin RD, Weinberger AH, Kim JH, Wu M, Galea S.Trends in anxiety among adults in the United States, 2008–2018: rapid increases among young adults. J Psychiatr Res. 2020;130:441–6. [DOI] [PubMed] [PMC]
Fuller-Thomson E, Sulman J.Depression and inflammatory bowel disease: findings from two nationally representative Canadian surveys. Inflamm Bowel Dis. 2006;12:697–707. [DOI] [PubMed]
Fuller-Thomson E, Lateef R, Sulman J.Robust association between inflammatory bowel disease and generalized anxiety disorder: findings from a nationally representative Canadian study. Inflamm Bowel Dis. 2015;21:2341–8. [DOI] [PubMed]
Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults. Am J Gastroenterol. 2018;113:481–517. Erratum in: Am J Gastroenterol. 2018;113:1101. [DOI] [PubMed]
Gaines LS, Slaughter JC, Horst SN, Schwartz DA, Beaulieu DB, Haman KL, et al. Association between affective-cognitive symptoms of depression and exacerbation of Crohn’s disease. Am J Gastroenterol. 2016;111:864–70. [DOI] [PubMed] [PMC]
Chablani SV, Ramos-Rivers C, Binion DG, Szigethy E.Depressive symptoms predict anti-tumor necrosis factor therapy noncompliance and healthcare utilization in patients with inflammatory bowel disease. Dig Dis Sci. 2018;63:2482–84. [DOI] [PubMed]
Marchioni Beery RM, Barnes EL, Nadkarni A, Korzenik JR.Suicidal behavior among hospitalized adults with inflammatory bowel disease: a United States nationwide analysis. Inflamm Bowel Dis. 2018;24:25–34. [DOI] [PubMed]
Tarar ZI, Zafar MU, Farooq U, Ghous G, Aslam A, Inayat F, et al. Burden of depression and anxiety among patients with inflammatory bowel disease: results of a nationwide analysis. Int J Colorectal Dis. 2022;37:313–21. [DOI] [PubMed]
Williet N, Sarter H, Gower-Rousseau C, Adrianjafy C, Olympie A, Buisson A, et al. Patient-reported outcomes in a french nationwide survey of inflammatory bowel disease patients. J Crohns Colitis. 2017;11:165–74. [DOI] [PubMed]
Bolton JM, Walld R, Chateau D, Finlayson G, Sareen J.Risk of suicide and suicide attempts associated with physical disorders: a population-based, balancing score-matched analysis. Psychol Med. 2015;45:495–504. [DOI] [PubMed]
Farraye FA, Melmed GY, Lichtenstein GR, Kane SV.ACG clinical guideline: preventive care in inflammatory bowel disease. Am J Gastroenterol. 2017;112:241–58. Erratum in: Am J Gastroenterol. 2017;112:1208. [DOI] [PubMed]
Davis SP, Bolin LP, Crane PB, Crandell J.Non-pharmacological interventions for anxiety and depression in adults with inflammatory bowel disease: a systematic review and meta-analysis. Front Psychol. 2020;11:538741. [DOI] [PubMed] [PMC]
