Author information

1 Department of Internal Medicine, University of California San Diego, La Jolla, California.

2 Division of Biomedical Informatics, University of California San Diego, La Jolla, California.

3 Division of Gastroenterology, University of California San Diego, La Jolla, California.

4 Division of Biomedical Informatics, University of California San Diego, La Jolla, California; Division of Gastroenterology, University of California San Diego, La Jolla, California. Electronic address: sis040@ucsd.edu.

Abstract

BACKGROUND AND AIMS: Approximately 15%-40% patients with inflammatory bowel diseases (IBD) are obese. There is an inconsistent association between obesity and IBD phenotype and course. We conducted a nationally representative cohort study to estimate and compare the burden, costs, and causes for hospitalization in obese vs. non-obese patients with IBD.

METHODS: Using the Nationwide Readmissions Database 2013, we identified obese (based on administrative claims code) and non-obese patients who had been hospitalized at least once, from January through June 2013, and followed them for re-hospitalization until December 2013. We compared annual burden (total days spent in hospital), costs, causes, and outcomes of hospitalization between obese and non-obese patients after 1:1 propensity score matching.

RESULTS: We identified 42,285 patients with IBD, of which 12.4% were obese. After propensity score matching, we included 5128 obese and 5128 non-obese IBD patients in our analysis. Compared to non-obese patients, obese patients spent more days in hospital annually (median, 8 vs. 5 days) (P<.01), with higher hospitalization-related costs (median, $17,277 vs. $11,847) (P<.01); this pattern persisted in subsets of high-need and high-cost patients. Compared to non-obese patients, obese patients were more likely to be hospitalized with preventable admissions (19% vs. 15%) or cardiopulmonary complications (16% vs. 12%).

CONCLUSIONS: In an analysis of data on patients with IBD from the Nationwide Readmissions Database 2013, we found obesity to be independently associated with higher burden and costs of hospitalizations. Strategies should be considered to target obesity as adjunctive therapy for patients with IBD.