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. 2016 Sep;22(9):2149-57.
doi: 10.1097/MIB.0000000000000870.

Impact of Specialized Inpatient IBD Care on Outcomes of IBD Hospitalizations: A Cohort Study

Cindy C Y Law  1 , Saranya Sasidharan, Rodrigo Rodrigues, Deanna D Nguyen, Jenny Sauk, John Garber, Cosmas Giallourakis, Ramnik Xavier, Hamed Khalili, Vijay Yajnik, Ashwin N Ananthakrishnan
Affiliations

Impact of Specialized Inpatient IBD Care on Outcomes of IBD Hospitalizations: A Cohort Study

Cindy C Y Law et al. Inflamm Bowel Dis. 2016 Sep.

Abstract

Background: The management of inflammatory bowel diseases (IBDs; Crohn's disease, ulcerative colitis) is increasingly complex. Specialized care has been associated with improved ambulatory IBD outcomes.

Aims: To examine if the implementation of specialized inpatient IBD care modified short-term and long-term clinical outcomes in IBD-related hospitalizations.

Methods: This retrospective cohort study included IBD patients hospitalized between July 2013 and April 2015 at a single tertiary referral center where a specialized inpatient IBD care model was implemented in July 2014. In-hospital medical and surgical outcomes as well as postdischarge outcomes at 30 and 90 days were analyzed along with measures of quality of in-hospital care. Effect of specialist IBD care was examined on multivariate analysis.

Results: A total of 408 IBD-related admissions were included. With implementation of specialized IBD inpatient care, we observed increased frequency of use of high-dose biologic therapy for induction (26% versus 9%, odds ratio 5.50, 95% confidence interval 1.30-23.17) and higher proportion of patients in remission at 90 days after discharge (multivariate odds ratio 1.60, 95% confidence interval 0.99-2.69). Although there was no difference in surgery by 90 days, among those who underwent surgery, early surgery defined as in-hospital or within 30 days of discharge, was more common in the study period (71%) compared with the control period (46%, multivariate odds ratio 2.73, 95% confidence interval 1.22-6.12). There was no difference in length of stay between the 2 years.

Conclusions: Implementation of specialized inpatient IBD care beneficially impacted remission and facilitated early surgical treatment.

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Conflict of interest statement

Ananthakrishnan has served on the scientific advisory boards for Abbvie, Exact Sciences, and Cubist pharmaceuticals and has received grant support from Cubist and Amgen. Khalili has received consultant fee from Abbvie. Yajnik has received consulting fees from NPS, Janssen Pharmaceuticals, and UCB.

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