DAY 1: Nationwide Analyses of Infection Burden, Risk Factors, and Outcomes Among Patients with IBD

Carol Singh, MBBS, from Dayanand Medical College and Hospital, shared results from a nationwide analysis of the impact of infections on outcomes in patients with ulcerative colitis (UC). The analysis included data on 826,945 patients with a diagnosis of UC in the National Inpatient Sample from 2016 to 2022; of which 36.2% developed infections. The most frequent infections were urinary tract infection (9.2%), hospital-acquired pneumonia (7.0%), and Clostridioides difficile infection (CDI; 6.2%). Any infection was associated with worse clinical outcomes compared to no infection, including mortality (4.9% vs. 1.3%), acute kidney insufficiency (28.5% vs. 14.8%), and ICU admissions (7.0% vs. 2.3%). They also found that inpatients with UC and infection were less likely to have had a surgical procedure. (P1053)

Rafia Ifran Waheed, MD, from University of South Dakota Sanford School of Medicine, reported findings from an analysis of the 2022 National Impatient Sample on the burden and outcomes of opportunistic infections among patients with IBD. The most common infection was C. difficile, followed by Candida and cytomegalovirus (CMV) infection. Prevalence was highest in women older than 50 years of age. An opportunistic infection was associated with a more than 2-fold higher odds of in-hospital mortality and an almost 5-fold higher odds of a longer length of hospital stay, the latter was associated with estimated average hospital charges of $50,000. Patients with IBD and at least one infection had a 3.6-fold higher risk of acute respiratory distress syndrome (ARDS) and 2.7-fold higher risk of sepsis. (P1072)

Chloe Lahoud, MD, from Staten Island University Hospital and Northwell Health, presented an analysis on the prevalence of CDI and mortality predictors among patients with and without IBD in the National Inpatient Sample database between 2016 and 2020. A total of 29,751,016 patients were included, 319,379 of whom had a diagnosis of IBD. More patients with IBD developed CDI than those without (4.3% vs. 0.9%), but had a lower risk of mortality associated with CDI than those without IBD (3.4% vs. 6.4%). The authors suggested that this finding may be related to the more frequent monitoring and testing of patients with IBD, leading to more timely treatment of CDI. Among patients with IBD, those with Crohn’s disease (CD) had a lower prevalence of CDI and lower risk of mortality compared to those with UC. Greater age, malnutrition, kidney disease, sepsis, intubation, and ICU stay were significantly associated with a higher mortality from CDI. (P3277)