Obesity in Inflammatory Bowel Disease Is Associated with Early Readmissions Characterised by an Increased Systems and Patient-level Burden

Abstract

Background & Aims Rates of obesity are rising in patients with inflammatory bowel disease. (IBD). We conducted a United States population-based study to determine the effects of obesity on outcomes in hospitalized patients with IBD. Methods We searched the Nationwide Readmissions Database from 2016-2017 to identify all adult patients hospitalized for IBD using ICD-10 codes. We compared obese (BMI ≥30) vs. non-obese (BMI <30) patients with IBD to evaluate the independent effects of obesity on readmission, mortality, and other hospital outcomes. Multivariate regression and propensity matching were performed. Results We identified 143,190 patients with IBD, of whom 9.1% were obese. Obesity was independently associated with higher all-cause readmission at 30- (18% vs 13% [aOR 1.16, p=0.005]) and 90-days (29% vs 21% [aOR 1.27, p<0.0001]), as compared to non-obese patients, with similar findings upon a propensity matched sensitivity analysis. Obese and non-obese patients had similar risks of mortality on index admission (0.24% vs 0.31%, p=0.18), and readmission (1.5% vs 1.8% p=0.3). Obese patients had longer (5.3 vs 4.9 days) and more expensive ($12,195 vs $11,154) hospitalizations on index admission. Obesity did not affect the risk of intestinal surgery or bowel obstruction. Compared to index admissions, readmissions were characterized by increased mortality (6-fold), healthcare use, and bowel obstruction (3-fold) (all p<0.0001). Conclusions Obesity in IBD appears to be associated with increased early readmission, characterized by a higher burden, despite the introduction of weight-based therapeutics. Prevention of obesity should be a focus in the treatment of IBD to decrease readmission and healthcare burden.

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Evaluating the Impact of Obesity and Different Metabolic Statuses on the Prognosis of Hospitalized Patients with Inflammatory Bowel Disease: A Cohort Study

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