Outcomes of Ulcerative Colitis in Octogenarians, Nonagenarians, and Centenarians: A Population-Based Study

Background: The US population is aging rapidly. There is limited data specifically for patients with Ulcerative Colitis (UC) who are older than or equal to 80 years old. We sought to examine the national inpatient sample database to describe in-hospital outcomes among these older 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 UC using international classification of diseases 10th revision codes. We then examined the outcomes in patients who were older than or equal to 80 years old (YO) vs. younger than 80 years old. Linear regression and multivariate logistic was used accordingly 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 1,311 (11.1%) patients were over or equal to the age of 80. Admissions with UC who were ≥ 80 YO had higher prevalence of hypertension (57.6% Vs 40.3 %, P< 0.001), diabetes mellitus (34.4% VS 27.4% p < 0.001), and chronic kidney disease (5.7% Vs 4.2%, P< 0.001). In-hospital mortality was higher among the older cohort (6.2% Vs 4.56, P< 0.001). On linear regression analysis, increased age was associated with increased in-hospital mortality (P< 0.001). On multivariable regression, age >80 years was associated with higher odds of inpatient mortality (OR 1.324, CI 1.246-1.407, P< 0.001)). It was also shown that older UC patients pay significantly more total hospital charges ($100,563 vs. $67,882, P< 0.001) with higher length of stay (7.2 days vs 6.4 days, P< 0.001). On secondary analysis it has shown that UC patients aged more than or equal to 80 years old had higher odds of having GI bleed (OR 2.083, CI 1.883-2.304, P< 0.001), Acute kidney injury (OR 1.259, CI 1.232-1.287, P< 0.001), Acute liver injury (OR 1.255, CI 1.220-1.259), Acute pancreatitis (OR 1.103, CI 1.063-1.145, P< 0.001), Congestive heart failure exacerbation (1.124, OR 1.121-1.127, P< 0.001), and arrythmia (OR1.299, 1.247-1.352, P< 0.001). Conclusions: In this nationally representative population-based retrospective cohort study, aging was associated with higher mortality and worse outcomes among patients with UC.