Hospitalizations for Crohn's Disease - United States, 2003-2013

Abstract

In 2009, an estimated 565,000 Americans had Crohn's disease (1), an inflammatory bowel disorder that can affect any part of the gastrointestinal tract. Symptoms include persistent diarrhea, abdominal cramps and pain, constipation leading to bowel obstruction, and rectal bleeding.* Symptoms sometimes intensify in severity and require hospitalization and surgeries of the small intestine, colon, or rectum (2). Hospital discharge data from the National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) were used to estimate U.S. hospitalizations^† for Crohn's disease as both the first-listed and any-listed^§ discharge diagnosis and common surgical procedures during hospitalizations with Crohn's disease as first-listed diagnosis from 2003 to 2013, the most recent decade of data. Despite new therapies that were expected to improve remission and reduce hospitalizations, estimated numbers (and age-adjusted rates per 100,000 U.S. population) of hospitalizations for Crohn's disease as the first-listed diagnosis did not change significantly from 2003 to 2013. The proportion of these hospitalizations during which small bowel resection was performed decreased from 4.9% in 2003 to 3.9% in 2013 (p<0.05); however, colorectal resection and fistula repair rates remained stable. Hospital stays for any-listed Crohn's disease increased from >120,000 (44.2 per 100,000) in 2003 to >196,000 (59.7 per 100,000) in 2013 (p<0.05). Patient education initiatives should focus on increasing awareness of exacerbating factors and medication compliance to prevent hospitalizations.

FIGURE 1

Age-adjusted hospitalization rate (per 100,000 population) for a first-listed or any-listed diagnosis of Crohn’s disease, by sex — National Inpatient Sample, United States, 2003–2013 *Age-adjusted to the 2000 projected U.S. population. ^† First-listed Crohn’s disease diagnosis indicates that Crohn’s disease was the principal reason for the hospitalization. Any-listed Crohn’s disease diagnosis indicates that patients had Crohn’s disease, but Crohn’s disease was not necessarily the main reason they were being hospitalized.

FIGURE 2

Age-adjusted hospitalization rate (per 100,000 population) for any-listed diagnosis of Crohn’s disease — State Inpatient Databases, 2013 * Age-adjusted to the 2000 projected U.S. population. ^† Estimates considered unstable if relative standard error >30%. ^§ Any-listed Crohn’s disease diagnosis indicates that patients had Crohn’s disease, but Crohn’s disease was not necessarily the main reason they were being hospitalized.