Burden and Predictors of Non-Alcoholic Fatty Liver Disease in a Retrospective Cohort of Patients With Crohn’s Disease

Abomhya, Ahmed; Mahmoodurrahman, Mohammed; Ayaz, Salman; Hamad, Hossam; Khan, Farrah

doi:10.14740/gr1509

Cited by 6 publications

(32 citation statements)

References 29 publications

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“…The second study reported an adjusted OR of 259; 95% CI: −787 to 1306, P = 0.627 [25,26]. However, Abomhya et al (215 049 patients) demonstrated an increase in median total hospitalization costs of 32 305.5 USD; IQR = 18 600-61 599 in NAFLD+IBD patients vs. 30 782 USD; IQR = 16 847-58 667, P < 0.001 for those with IBD alone [18]. Noorian et al also showed increased cost of care (COC) in patients with IBD and NAFLD ranging from 7223 to 7634 USD; 95% CI: 923-17 116, P < 0.01 in CD (18 170 patients) and 8358 to 9392 USD; 95% CI: 3200-14 662, P < 0.01 in UC patients (9866 patients) [19].…”

Section: Hospitalization Costmentioning

confidence: 93%

“…33 [ 23,27], and an adjusted hazard ratio of 2.5; 95% CI: 1.3-4.9 [23,27], as reported in Table 2. The third study did not report hospitalization rates [18,19,[24][25][26].…”

Section: Hospitalization Ratesmentioning

confidence: 99%

“…Only one cohort included and evaluated CD and UC patients separately (n = 18 170 CD and n = 9866 UC patients) [19]. Three articles included only patients with CD (n = 216 206) [18,23,27]. Additional patient characteristics are listed in Table 2.…”

Section: Patient Populationmentioning

confidence: 99%

“…Only two inpatient cohorts assessed mortality with one reporting an adjusted OR of 1.7; 95% CI: 1.1-2.6, P < 0.03 in patients with NAFLD+IBD [18,25] as seen in Table 2. However, the adjusted odds of mortality were 0.64; 95% CI: 0.47-0.89, P < 0.009 in NAFLD+IBD patients in the other [25].…”

Section: Inpatient Mortalitymentioning

confidence: 99%

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The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Boustany

Rahhal

Mitri

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Evidence suggests that patients with inflammatory bowel disease are at higher risk of developing nonalcoholic fatty liver disease (NAFLD). However, there is limited information currently available on how NAFLD may affect the clinical course of IBD. Thus, we conducted a systematic review to evaluate the impact of NAFLD on IBD-related hospitalization outcomes. All observational studies assessing IBD-related hospitalization outcomes in patients with NAFLD were included. Exclusion criteria were studies published in languages other than English or French, or those involving pediatric population. Outcomes included IBD-related hospitalization and readmission rates, need for surgery, length of stay, inpatient mortality, and costs. Overall, 3252 citations were retrieved and seven studies met the inclusion criteria (1 574 937 patients); all were observational, of high quality, and originated in the United States. Measurable outcomes reported in these studies were few and with insufficient similarity across studies to complete a quantitative assessment. Only one study reports NAFLD severity. Two studies suggested a higher rate of hospitalization for patients with both NAFLD and IBD compared to IBD alone (incidence rate ratio of 1.54; 95% confidence interval: 1.33–1.79). This is the first systematic review to date that evaluates any possible association of NAFLD with IBD-related hospitalization outcomes. Despite the paucity and low quality of available data, our findings indicate that NAFLD may be associated with worse outcomes amongst IBD patients (especially Crohn’s disease). Further and higher certainty of evidence is needed for better characterization of such clinical impact.

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Section: Hospitalization Costmentioning

confidence: 93%

“…33 [ 23,27], and an adjusted hazard ratio of 2.5; 95% CI: 1.3-4.9 [23,27], as reported in Table 2. The third study did not report hospitalization rates [18,19,[24][25][26].…”

Section: Hospitalization Ratesmentioning

confidence: 99%

Section: Patient Populationmentioning

confidence: 99%

Section: Inpatient Mortalitymentioning

confidence: 99%

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The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Boustany

Rahhal

Mitri

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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“…This is a retrospective cohort study of patients discharged with a diagnosis of CD between 2016 and 2018. The study was performed in accordance with the 1963 Helsinki Declaration and is exempt from an Institutional Review Board due to the lack of any identifying patient information [17,18].…”

Section: Data Source and Study Designmentioning

confidence: 99%

Prevalence and Impact of Acute Pancreatitis on Hospitalization Outcomes in a Cohort of Patients With Crohn’s Disease

et al. 2022

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Background: Few studies evaluated the risk of acute pancreatitis (AP) in patients with Crohn's disease (CD). It's controversial if AP can be considered as an extraintestinal manifestation of CD. We studied this potential association in a retrospective cohort of patients with CD.Methods: We draw our cohort from the Nationwide Readmission Databases 2016 -2018. We used the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify all adult patients admitted with a diagnosis of CD. Patient with a comorbid AP were identified. We analyzed the significant impact of AP on hospitalization outcomes. A multivariate regression analysis was used to identify factors associated with AP. Results:We included 214,622 patients discharged from an index hospitalization for CD, 1.1% had AP. AP was independently associated with higher odds of inpatient mortality (odds ratio (OR): 1.831; 95% confidence interval (CI): 1.345 -2.492, P < 0.001), gallstone disease (OR: 4.047; 95% CI: 3.343 -4.9, P < 0.001), nonalcoholic fatty liver disease (NAFLD) (OR: 3.568; 95% CI: 3.08 -4.133, P < 0.001), and hypercalcemia (OR: 1.964; 95% CI: 1.302 -2.965, P = 0.001). Thirtyday readmission analysis showed that CD patients with AP were more commonly to be readmitted for AP than for any other reason. Conclusions:In our nationwide cohort of CD patients, there was a significant association between AP and worse hospitalization outcomes. Additionally, we found independent associations for having AP that may help identify patients at high risk.

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Prevalence of Hepatobiliary Manifestations in Inflammatory Bowel Disease: A GRADE Assessed Systematic Review and Meta-Analysis of more than 1.7 Million Patients

Beheshti Maal,

Shahrbaf,

Sadri

et al. 2023

Journal of Crohn's and Colitis

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Background and Aims Background: Inflammatory bowel disease (IBD) is an immune-mediated group of chronic gastrointestinal (GI) disorders. Patients with IBD may experience extraintestinal manifestations, such as the hepatobiliary complications. This meta-analysis aims to assess the prevalence of different hepatic manifestations in IBD patients. Methods For this systematic review and meta-analysis, PubMed, Scopus, Web of Science, and Embase were searched until July 20, 2022, by specifying keywords for IBD, hepatic manifestations, and study type. Full texts of cohort studies in English that examined the prevalence of different hepatic manifestations were included in this study. The primary outcome was the overall prevalence of hepatic manifestations in IBD patients. For the statistical analysis, a proportion by random effect model meta-analysis was performed. The registration number for the protocol of this study in PROSPERO is CRD42022369595. Results From the 4,421 articles retrieved from the primary search, 118 met the inclusion criteria and were included in the final analysis. After a pooled analysis of 1,729,128 patients, the overall prevalence of hepatic manifestations was 3.49% (95% CI: 3.31%-3.68%; I 2: 99.55%). The pooled prevalence of non-alcoholic fatty liver disease (NAFLD) in 228,216 patients was 26.1% (95% CI: 22.1–30.2%; I 2: 99.018%). After pooled analysis of 9,642 patients, the prevalence of primary sclerosing cholangitis (PSC) was 1.67% (95% CI: 1.47-1.88%; I 2: 99.10%). The pooled prevalence of biliary stones was considered to be 4.1% (95% CI: 3.6-4.7%; I 2: 97.43%). Autoimmune hepatitis [0.51% (95% CI: 0.26-0.75%; I 2: 85.36%)] and portal vein thrombosis (PVT) [0.21% (95% CI: 0.08-0.33%; I 2: 97.95%] are considered as rare manifestations. Conclusion This study summarizes the prevalence and importance of different hepatic manifestations in IBD patients. These findings are crucial for the management of EIMs, especially hepatic manifestations, in IBD patients.

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Burden and Predictors of Non-Alcoholic Fatty Liver Disease in a Retrospective Cohort of Patients With Crohn’s Disease

Cited by 6 publications

References 29 publications

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Prevalence and Impact of Acute Pancreatitis on Hospitalization Outcomes in a Cohort of Patients With Crohn’s Disease

Prevalence of Hepatobiliary Manifestations in Inflammatory Bowel Disease: A GRADE Assessed Systematic Review and Meta-Analysis of more than 1.7 Million Patients

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