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Serological, genetic and clinical associations with increased health‐care resource utilization in inflammatory bowel disease
Author(s) -
Gu Phillip,
Kapur Anshika,
Li Dalin,
Haritunians Talin,
Vasiliauskas Eric,
Shih David Q,
Targan Stephan R,
Spiegel Brennan MR,
Mcgovern Dermot PB,
Black Jeanne T,
Melmed Gil Y
Publication year - 2018
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12566
Subject(s) - medicine , inflammatory bowel disease , ulcerative colitis , disease , logistic regression , confidence interval , emergency department , serology , univariate analysis , multivariate analysis , intensive care medicine , immunology , antibody , psychiatry
OBJECTIVE Inflammatory bowel diseases (IBD) are associated with significant morbidity and economic burden. The variable course of IBD creates a need for predictors of clinical outcomes and health resource utilization (HRU) to guide treatment decisions. We aimed to identify clinical, serological or genetic markers associated with inpatient resource utilization in patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS Patients with IBD with available genetic and serological data who had at least one emergency department visit or hospitalization in a 3‐year period were included. The primary outcome measure was HRU, as measured by the All Patient Refined Diagnosis Related Group classification system. Univariate and multivariate linear and logistic regression models were used to identify the associations with HRU. RESULTS Altogether 858 (562 CD and 296 UC) patients were included. Anti‐CBir1 seropositivity ( P = 0.002, effect size [ES]: 0.762, 95% confidence interval [CI] 0.512–1.012) and low socioeconomic status ( P = 0.005, ES: 1.620 [95% CI 1.091–2.149]) were independently associated with a high HRU. CD diagnosis ( P = 0.006, ES: –0.701 [95% CI –0.959 to –0.443]) was independently associated with a low inpatient HRU. CONCLUSION In patients with IBD who required at least one emergency department visit or hospitalization, anti‐CBir1 antibody status may be a useful biomarker of HRU when formulating management strategies to reduce disease complications and resource utilization.