Clinical Outcomes for Crohn’s Disease Patients With Thrombocytopenia: A Retrospective Cohort Study
Background:
Crohn’s disease is a type of chronic inflammatory bowel disease (IBD), characterized by transmural inflammation of both small and large bowel, leading to persistent abdominal pain, diarrhea, and other potential complications. Thrombocytopenia is a common cause of easy bruising and acute bleeds. There is limited data specifically for patients with Crohn’s disease who have thrombocytopenia. We sought to examine the national inpatient sample database to describe in-hospital outcomes among these patients.
Methods:
Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was analyzed to compare hospitalizations of adult Crohn’s disease patients with thrombocytopenia to those without, using <italic>International Classification of Diseases, Tenth Revision</italic> (ICD-10) codes. Multivariate logistic was used to adjust for confounders. The primary outcome was inpatient mortality. SPSS software was used for statistical analysis.
Results:
This study included 74,743 with Crohn’s disease of which 4554 (6.09%) patients had thrombocytopenia. Crohn’s disease patients with thrombocytopenia had a higher prevalence of CKD (21.48% vs 14.00%, <italic>P<</italic> 0.001), hypertension (24.64% Vs 17.00%, <italic>P<</italic> 0.001). Those patients were less likely to smoke (20.83% Vs 21.82%, <italic>P<</italic> 0.001). In-hospital mortality was higher among the patients who had thrombocytopenia (3.67% Vs 1.5% <italic>P<</italic> 0.001). Multivariate regression showed that Crohn’s disease patients with thrombocytopenia had higher inpatient mortality (OR 1.169, CI 1.142-1.197, <italic>P<</italic> 0.001). On secondary analysis, it has shown that Crohn’s disease patients with thrombocytopenia had higher odds of having shock (OR 1.208, CI 1.174-1.242, <italic>P<</italic> 0.001), acute hepatitis (OR 1.549, CI 1.482-1.621, <italic>P<</italic> 0.001), heart failure (OR 1.099, CI 1.092-1.106, <italic>P<</italic> 0.001), solid tumors (OR 1.125, CI 1.042-1.215, <italic>P<</italic> 0.001), hematuria (OR 1.108, CI 1.092-1.125, <italic>P<</italic> 0.001), pulmonary hypertension (OR 1.195, CI 1.169-1.221, <italic>P<</italic> 0.001), and intracranial hemorrhage (OR 1.151, 1.100-1.203, <italic>P<</italic> 0.001).
Conclusions:
In this nationally representative population-based retrospective cohort study, thrombocytopenia was associated with higher mortality and worse outcomes among patients who are diagnosed with Crohn’s disease.
