Original Contribution | Published:

IBD

Does It Matter Where You Are Hospitalized for Inflammatory Bowel Disease? A Nationwide Analysis of Hospital Volume

The American Journal of Gastroenterology volume 103, pages 27892798 (2008) | Download Citation

Subjects

Abstract

OBJECTIVE:

 To examine if a high hospital volume was associated with superior outcomes in inflammatory bowel disease (IBD) patients requiring hospitalization.

METHODS:

 This was a cross-sectional study using data from the Nationwide Inpatient Sample (NIS 2004). IBD-related hospitalizations were identified using appropriate International Classification of Diseases, Ninth revision, Clinical modification (ICD-9-CM) codes. Hospital volume was divided into low, medium, and high by assigning the threshold cutoff values of 1–50, 51–150, and >150 annual IBD hospitalizations, respectively. Our primary outcomes were in-hospital mortality, length of stay, and postoperative complications and stay.

RESULTS:

 Patients at high-volume centers were more likely to be hospitalized with fistulizing or stricturing disease. The adjusted mortality was lower for IBD-related discharges from high-volume centers for those undergoing abdominal surgery (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.18–0.78), but not among those who did not undergo surgery (OR 0.90, 95% CI 0.53–1.52). Patients at high-volume centers were also more likely to undergo surgery (OR 2.24, 95% CI 1.40–3.58). These differences were more prominent in Crohn's disease than in ulcerative colitis.

CONCLUSION:

 Hospitals with a high annual IBD volume have lower in-hospital mortality among surgical IBD patients. This suggests a need for future research into identifying the quality-of-care measures in IBD and instituting appropriate interventions to improve overall IBD outcomes.

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Author information

Affiliations

  1. Divisions of Gastroenterology and Hepatology, Milwaukee, Wisconsin

    • Ashwin N Ananthakrishnan
    •  & David G Binion
  2. Epidemiology, Medical College of Wisconsin, Milwaukee, Wisconsin

    • Emily L McGinley

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Corresponding author

Correspondence to David G Binion.

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DOI

https://doi.org/10.1111/j.1572-0241.2008.02054.x

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