BACKGROUND: The management of inflammatory bowel diseases (IBDs; Crohn's disease, ulcerative colitis) is increasingly complex. Specialized care has been associated with improved ambulatory IBD outcomes. AIMS: To examine if the implementation of specialized inpatient IBD care modified short-term and long-term clinical outcomes in IBD-related hospitalizations. METHODS: This retrospective cohort study included IBD patients hospitalized between July 2013 and April 2015 at a single tertiary referral center where a specialized inpatient IBD care model was implemented in July 2014. In-hospital medical and surgical outcomes as well as postdischarge outcomes at 30 and 90 days were analyzed along with measures of quality of in-hospital care. Effect of specialist IBD care was examined on multivariate analysis. RESULTS: A total of 408 IBD-related admissions were included. With implementation of specialized IBD inpatient care, we observed increased frequency of use of high-dose biologic therapy for induction (26% versus 9%, odds ratio 5.50, 95% confidence interval 1.30-23.17) and higher proportion of patients in remission at 90 days after discharge (multivariate odds ratio 1.60, 95% confidence interval 0.99-2.69). Although there was no difference in surgery by 90 days, among those who underwent surgery, early surgery defined as in-hospital or within 30 days of discharge, was more common in the study period (71%) compared with the control period (46%, multivariate odds ratio 2.73, 95% confidence interval 1.22-6.12). There was no difference in length of stay between the 2 years. CONCLUSIONS: Implementation of specialized inpatient IBD care beneficially impacted remission and facilitated early surgical treatment.
BACKGROUND: The management of inflammatory bowel diseases (IBDs; Crohn's disease, ulcerative colitis) is increasingly complex. Specialized care has been associated with improved ambulatory IBD outcomes. AIMS: To examine if the implementation of specialized inpatient IBD care modified short-term and long-term clinical outcomes in IBD-related hospitalizations. METHODS: This retrospective cohort study included IBD patients hospitalized between July 2013 and April 2015 at a single tertiary referral center where a specialized inpatient IBD care model was implemented in July 2014. In-hospital medical and surgical outcomes as well as postdischarge outcomes at 30 and 90 days were analyzed along with measures of quality of in-hospital care. Effect of specialist IBD care was examined on multivariate analysis. RESULTS: A total of 408 IBD-related admissions were included. With implementation of specialized IBD inpatient care, we observed increased frequency of use of high-dose biologic therapy for induction (26% versus 9%, odds ratio 5.50, 95% confidence interval 1.30-23.17) and higher proportion of patients in remission at 90 days after discharge (multivariate odds ratio 1.60, 95% confidence interval 0.99-2.69). Although there was no difference in surgery by 90 days, among those who underwent surgery, early surgery defined as in-hospital or within 30 days of discharge, was more common in the study period (71%) compared with the control period (46%, multivariate odds ratio 2.73, 95% confidence interval 1.22-6.12). There was no difference in length of stay between the 2 years. CONCLUSIONS: Implementation of specialized inpatient IBD care beneficially impacted remission and facilitated early surgical treatment.
Authors: Mark S Silverberg; Jack Satsangi; Tariq Ahmad; Ian D R Arnott; Charles N Bernstein; Steven R Brant; Renzo Caprilli; Jean-Frédéric Colombel; Christoph Gasche; Karel Geboes; Derek P Jewell; Amir Karban; Edward V Loftus; A Salvador Peña; Robert H Riddell; David B Sachar; Stefan Schreiber; A Hillary Steinhart; Stephan R Targan; Severine Vermeire; B F Warren Journal: Can J Gastroenterol Date: 2005-09 Impact factor: 3.522
Authors: Gilaad G Kaplan; Ellen P McCarthy; John Z Ayanian; Joshua Korzenik; Richard Hodin; Bruce E Sands Journal: Gastroenterology Date: 2008-01-10 Impact factor: 22.682
Authors: Mahmoud H Mosli; William J Sandborn; Richard B Kim; Reena Khanna; Bandar Al-Judaibi; Brian G Feagan Journal: Am J Gastroenterol Date: 2014-05-20 Impact factor: 10.864
Authors: Johannan F Brandse; Gijs R van den Brink; Manon E Wildenberg; Desiree van der Kleij; Theo Rispens; Jeroen M Jansen; Ron A Mathôt; Cyriel Y Ponsioen; Mark Löwenberg; Geert R A M D'Haens Journal: Gastroenterology Date: 2015-04-25 Impact factor: 22.682
Authors: Andres J Yarur; Maria T Abreu; Amar R Deshpande; David H Kerman; Daniel A Sussman Journal: World J Gastroenterol Date: 2014-04-07 Impact factor: 5.742
Authors: Perseus V Patel; Matthew S Pantell; Melvin B Heyman; Sofia Verstraete Journal: J Pediatr Gastroenterol Nutr Date: 2019-11 Impact factor: 2.839
Authors: G Pellino; D S Keller; G M Sampietro; V Annese; M Carvello; V Celentano; C Coco; F Colombo; N Cracco; F Di Candido; M Franceschi; S Laureti; G Mattioli; L Pio; G Sciaudone; G Sica; V Villanacci; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-01-25 Impact factor: 3.781
Authors: Nienke Z Borren; Hamed Khalili; Jay Luther; Francis P Colizzo; John J Garber; Ashwin N Ananthakrishnan Journal: Inflamm Bowel Dis Date: 2019-03-14 Impact factor: 5.325
Authors: Martina Scharitzer; Bernd Koizar; Harald Vogelsang; Michael Bergmann; Christian Primas; Michael Weber; Wolfgang Schima; Thomas Mang Journal: Eur Radiol Date: 2020-05-26 Impact factor: 5.315