Effects of NSTEMI on Patients With Ulcerative Colitis: Insights From the National Inpatient Sample

Background: There is a paucity of data looking specifically on the effects of NSTEMI on patients with ulcerative colitis (UC). We sought to analyze this relationship further by examining the national inpatient sample database to describe in-hospital trends and outcomes among those patients. Methods: Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was searched for hospitalizations of adult patients with ulcerative colitis with and without a concomitant diagnosis of NSTEMI using international classification of diseases-10th revision codes. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. Secondary outcomes were hospital length of stay (LOS), and total hospital charges (TOTHCG). SPSS software was used for statistical analysis. Results: This study included 11,762 patients with ulcerative Colitis, of which 2,698 (22.9%) patients were diagnosed with NSTEMI. Admissions with UC and NSTEMI had higher prevalence of hypertension (45.6% Vs 40.3 %, P< 0.001), diabetes mellitus (32.4% VS 27.4% p < 0.001), and chronic kidney disease (5.3% Vs 4.2%, P< 0.001). Multivariate regression showed that patients with both ED and NSTEMI had higher inpatient mortality compared to those with ED alone (OR 1.245, CI 1.181-1.313, P< 0.001). It was also shown that UC with NSTEMI patients pay significantly more total hospital charges ($80,567 vs. $67,882, P< 0.001) with higher length of stay (7.5 days vs 6.4 days, P< 0.001). On secondary analysis it was shown that UC patients with NSTEMI had higher odds of developing GI bleed (OR 1.298, CI 1.254-1.344, P< 0.001), Ventricular arrhythmia (OR 1.269, CI 1.162-1.387, P< 0.001), acute kidney injury (OR 1.302,CI 1.272-1.133, P< 0.001), congestive heart failure exacerbation (OR 1.347, CI 1.255-1.445, P< 0.001), and acute hepatitis (OR 1.263, CI 1.183-1.349, P< 0.001). Conclusions: In this nationally representative population-based retrospective cohort study, we concluded that UC patients hospitalized with NSTEMI have increased in-hospital mortality and worse outcomes. More research is needed in this area.