Clinical Outcomes of Obese Patients With Crohn's Disease: 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. Obesity is increasing in prevalence among the US population. There is limited data specifically for patients with obese patients with Crohn’s disease. 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 searched for hospitalizations of adult Crohn’s disease patients who are obese using the <italic>International Classification of Diseases Tenth Revision</italic> 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 6,304 (8.4%) patients were obese. Patients that are obese with Crohn’s disease had a higher prevalence of CKD (16.16% Vs 14.00%, <italic>P<</italic> 0.001), hypertension (22.84% Vs 17.00%, <italic>P<</italic> 0.001), and smoking (26.17% Vs 21.82%, <italic>P<</italic> 0.001). In-hospital mortality was higher among obese patients (17.40% Vs 1.5% <italic>P<</italic> 0.001). Multivariate regression showed that patients with obesity and Crohn’s disease had higher inpatient mortality (OR 1.052, CI 1.038-1.066, <italic>P<</italic> 0.001). On secondary analysis, it has shown that patients with obesity and Crohn’s disease had higher odds of having acute hepatitis (OR 1.549, CI 1.482-1.621, <italic>P<</italic> 0.001), left bundle branch block (OR 1.112, CI 1.080-1.145, <italic>P<</italic> 0.001), CKD (OR 1.108, CI 1.101-1.115, <italic>P<</italic> 0.001), sepsis (OR 1.087, CI 1.081-1.092, <italic>P<</italic> 0.001), hyperlipidemia (OR 1.600, CI 1.570-1.631, <italic>P<</italic> 0.001), esophagitis (OR 1.126, CI 1.120-1.131, <italic>P<</italic> 0.001), and stroke (OR 1.114, 1.103-1.124, <italic>P<</italic> 0.001).
Conclusions:
In this nationally representative population-based retrospective cohort study, obesity was associated with higher mortality and worse outcomes among patients who are diagnosed with Crohn’s disease.
