Patients hospitalized for sepsis who have a history of inflammatory bowel diseases experience higher rates of mortality, acute kidney injury, and septic shock, as well as longer lengths of hospital stay and increased use of health care resources, according to research being presented at the American College of Chest Physicians (CHEST) 2022 Annual Meeting, held October 16 to 19, in Nashville, Tennessee.
Investigators sought to analyze the clinical outcomes of sepsis in patients with a history of CD and UC. The primary outcome was mortality difference; secondary outcomes included sepsis complications, length of hospital stay, and cost of care.
The researchers initiated a retrospective analysis of 8,409,258 patients (mean age 65 years; 50% female) in the National Inpatient Sample Database from 2016 to 2019 who were hospitalized for sepsis, as identified from ICD-10 codes. In this study sample, the mean length of stay was 7.1 days; mean hospital cost was $79,613. Within the study sample, 61,495 had a history of CD and 47,544 has a history of UC; the remaining patients served as the control group.
Investigators found the adjusted odds ratio (OR) for mortality, as compared with the control population, was higher in patients with UC than CD (OR 1.09; 95% CI, 1.02-1.18; P =.014 vs OR 0.85; 95% CI, 0.79-0.92; P <.001). Investigators also found an increased risk of septic shock in UC (OR 1.35; 95% CI, 1.29-1.42; P <.001) and CD (OR 1.12; 95% CI, 1.07-1.17; P <.001) compared with the control population.
Additionally, an increased risk of acute kidney injury (AKI) was seen in those with UC (OR 1.21; 95% CI, 1.16-1.26; P <.001) and CD (OR 1.14; 95% CI, 1.10-1.18; P <.001) compared with those in the control group. Notably, the UC group had a higher risk for septic shock and AKI than the CD group.
Investigators also found that patients in both the UC and CD groups had significantly longer lengths of stay and significantly greater mean hospital costs than those in the control group.
Investigators concluded that “Patients admitted with sepsis have worse outcomes in the setting of inflammatory bowel diseases, represented by higher rates of mortality, septic shock, acute kidney injury, prolonged length of stay, and increased resources utilization.” They reiterated that patients with sepsis and comorbid UC experience all of these outcomes with greater severity than patients with sepsis and comorbid CD.
Aldiabat M, Yusuf M, Al-Khateeb M, et al. Sepsis in the settings of inflammatory bowel disease: studying the outcomes of more than 8 million patients. Presented at: CHEST 2022 Annual Meeting; October 16-19, 2022; Nashville, TN.