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Original Article
Aug 2011

Risk of Comorbidities on Postoperative Outcomes in Patients With Inflammatory Bowel Disease

Author Affiliations

Author Affiliations: Inflammatory Bowel Disease Clinic (Drs Kaplan, Panaccione, and Ghosh and Mr Hubbard), and Departments of Medicine (Drs Kaplan, Panaccione, Shaheen, Ghosh, and Myers and Mr Hubbard), Community Health Sciences (Drs Kaplan, Quan, and Dixon), and Surgery (Dr Dixon), University of Calgary, Alberta; and Mount Sinai Hospital, University of Toronto School of Medicine, Ontario (Dr Nguyen), Canada. Dr Kaplan is now with the Teaching Research and Wellness Center, Calgary, Alberta, Canada.

Arch Surg. 2011;146(8):959-964. doi:10.1001/archsurg.2011.194
Abstract

Background The effect of comorbidities on postoperative outcomes in patients with inflammatory bowel disease (IBD) has not been explored adequately. We evaluated the prevalence of comorbidities and their effect on postoperative outcomes after an IBD-related operation.

Methods The Nationwide Inpatient Sample database was used to identify 35 588 patients with IBD who underwent an IBD-related operation from January 1, 1995, through December 31, 2005. The presence of comorbid illness was assessed using the Elixhauser index. Multiple logistic regression analysis was performed to evaluate the effect of comorbidities on mortality rate after adjusting for age, sex, race, health insurance status, and admission type. Linear regression models were used to evaluate health care resource use.

Results Postoperative mortality was 1.9%. As the number of comorbidities increased (ie, 0, 1, 2, or ≥3), postoperative mortality increased (0.4%, 1.5%, 3.3%, and 7.9%, respectively). Congestive heart failure (odds ratio, 3.50 [95% confidence interval, 2.63-4.62]), liver disease (3.15 [2.00-4.97]), thromboembolic disease (4.19 [3.37-5.21]), and renal disease (8.74 [5.44-14.05]) were associated with a significant increase in mortality rate. Comorbidities associated with an increased risk of mortality also were associated with a significant increase in length of stay and hospital charges.

Conclusions Comorbidities were common in patients with IBD and they significantly increased the risk of postoperative mortality and health care use in patients with IBD.

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