Clin Gastroenterol Hepatol. 2023 Aug;21(9):2211-2221.doi: 10.1016/j.cgh.2022.06.030. Epub 2022 Jul 19.

Michael J Buie ¹, Joshua Quan ², Joseph W Windsor ¹, Stephanie Coward ¹, Tawnya M Hansen ³, James A King ⁴, Paulo G Kotze ⁵, Richard B Gearry ⁶, Siew C Ng ⁷, Joyce W Y Mak ⁷, Maria T Abreu ⁸, David T Rubin ⁹, Charles N Bernstein ¹⁰, Rupa Banerjee ¹¹, Jesus K Yamamoto-Furusho ¹², Remo Panaccione ¹³, Cynthia H Seow ¹, Christopher Ma ¹³, Fox E Underwood ¹, Vineet Ahuja ¹⁴, Nicola Panaccione ¹³, Abdel-Aziz Shaheen ¹, Jayna Holroyd-Leduc ¹, Gilaad G Kaplan ¹⁵; Global IBD Visualization of Epidemiology Studies in the 21st Century (GIVES-21) Research Group; Domingo Balderramo ¹⁶, Vui Heng Chong ¹⁷, Fabián Juliao-Baños ¹⁸, Usha Dutta ¹⁹, Marcellus Simadibrata ²⁰, Jamilya Kaibullayeva ²¹, Yang Sun ²², Ida Hilmi ²³, Raja Affendi Raja Ali ²⁴, Mukesh Sharma Paudel ²⁵, Mansour Altuwaijri ²⁶, Juanda Leo Hartono ²⁷, Shu Chen Wei ²⁸, Julajak Limsrivilai ²⁹, Sara El Ouali ³⁰, Beatriz Iade Vergara ³¹, Viet Hang Dao ³², Paul Kelly ³³, Phoebe Hodges ³³, Yinglei Miao ²², Maojuan Li ²²

Author information

¹Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

²Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

³Section of Gastroenterology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

⁴Centre for Health Informatics, University of Calgary, Calgary, Alberta, Canada; Alberta Strategy for Patient Oriented Research Support Unit, Data Platform and Provincial Research Data Services, Alberta Health Services, Calgary, Alberta, Canada.

⁵Inflammatory Bowel Disease Outpatient Clinics, Catholic University of Paraná, Curitiba, Brazil.

⁶Department of Medicine, University of Otago, Christchurch, New Zealand.

⁷Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.

⁸Department of Medicine and Microbiology and Immunology, University of Miami, Miami, Florida.

⁹Inflammatory Bowel Disease Center, University of Chicago, Chicago, Illinois.

¹⁰Inflammatory Bowel Disease Clinical and Research Centre, Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

¹¹Inflammatory Bowel Disease Center, Asian Institute of Gastroenterology, Hyderabad, India.

¹²Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition, National Autonomous University of Mexico, Mexico City, Mexico.

¹³Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

¹⁴Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

¹⁵Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: ggkaplan@ucalgary.ca.

¹⁶Gastroenterology Department, Hospital Privado Universitario de Córdoba, Córdoba, Argentina.

¹⁷Division of Gastroenterology and Hepatology, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam.

¹⁸Department of Gastroenterology, Pablo Tobon Uribe Hospital, Medellín, Colombia.

¹⁹Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

²⁰Division of Gastroenterology, Department Internal Medicine, Faculty Medicine, Dr. Cipto Mangunkusumo Hospital Indonesia, Universitas Indonesia, Jakarta, Indonesia.

²¹Research Institute of Cardiology and Internal Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.

²²Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan, China; Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China.

²³Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

²⁴Gastroenterology Unit, Gut Research Group, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

²⁵Department of Gastroenterology, National Academy of Medical Sciences, Kathmandu, Nepal.

²⁶Division of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

²⁷Yong Loo Lin School of Medicine, National University of Singapore, Division of Gastroenterology and Hepatology, National University Hospital, Singapore.

²⁸Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.

²⁹Division of Gastroenterology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

³⁰Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

³¹Centro de Asistencia del Sindicato Médico del Uruguay Cooperativa de Servicios Médicos, Montevideo, Uruguay.

³²Internal Medicine, Hanoi Medical University, Hanoi, Vietnam.

³³Blizard Institute, Barts and The London School of Medicine, Queen Mary University of London, London, England, United Kingdom; Tropical Gastroenterology and Nutrition Group, University of Zambia School of Medicine, Lusaka, Zambia.

Abstract

Background & aims: The evolving epidemiologic patterns of inflammatory bowel disease (IBD) throughout the world, in conjunction with advances in therapeutic treatments, may influence hospitalization rates of IBD. We performed a systematic review with temporal analysis of hospitalization rates for IBD across the world in the 21st century.

Methods: We systematically reviewed Medline and Embase for population-based studies reporting hospitalization rates for IBD, Crohn's disease (CD), or ulcerative colitis (UC) in the 21st century. Log-linear models were used to calculate the average annual percentage change (AAPC) with associated 95% confidence intervals (95% CIs). Random-effects meta-analysis pooled country-level AAPCs. Data were stratified by the epidemiologic stage of a region: compounding prevalence (stage 3) in North America, Western Europe, and Oceania vs acceleration of incidence (stage 2) in Asia, Eastern Europe, and Latin America vs emergence (stage 1) in developing countries.

Results: Hospitalization rates for a primary diagnosis of IBD were stable in countries in stage 3 (AAPC, -0.13%; 95% CI, -0.72 to 0.97), CD (AAPC, 0.20%; 95% CI, -1.78 to 2.17), and UC (AAPC, 0.02%; 95% CI, -0.91 to 0.94). In contrast, hospitalization rates for a primary diagnosis were increasing in countries in stage 2 for IBD (AAPC, 4.44%; 95% CI, 2.75 to 6.14), CD (AAPC, 8.34%; 95% CI, 4.38 to 12.29), and UC (AAPC, 3.90; 95% CI, 1.29 to 6.52). No population-based studies were available for developing regions in stage 1 (emergence).

Conclusions: Hospitalization rates for IBD are stabilizing in countries in stage 3, whereas newly industrialized countries in stage 2 have rapidly increasing hospitalization rates, contributing to an increasing burden on global health care systems.