Prevalence and predictors of hospitalization and re-hospitalization in Crohn's disease in a population based inception cohort between 2000 – 2012

• Published in: Zeitschrift für Gastroenterologie
• Main Authors: Golovics, P, Mandel, M, Lakatos, L, Lovász, B, Végh, Z, Szita, I, Mester, G, Balogh, M, Molnár, C, Komáromi, E, Mohás, A, Szilágyi, B, Fekete, S, Kiss, L, Lakatos, P
• Format: Conference Proceeding
• Language: English; German
• Published: 16.05.2013
• ISSN: 0044-2771; 1439-7803
• DOI: 10.1055/s-0033-1347470

Background and aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively the prevalence and predictors of hospitalization and re-hospitalization in a population based inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 304 incident CD patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (median age at diagnosis: 32.2; SD: 15.4years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first hospitalization and first re-hospitalization were 54.9%, 72% 76% and 22.8%, 34%, 52.3% after 1, 2 and 5 years of follow-up in Kaplan-Meier analysis. Main reasons for hospitalization in the first year were diagnostic procedures (48.5%), IBD related surgery (29.9%) and disease activity (14.3%). Non-inflammatory disease behavior at diagnosis (HR: 1.41, 95% CI: 1.41 – 1.89, p = 0.02) was the only factor significantly associated with time to hospitalization while both non-inflammatory disease behavior at diagnosis (HR: 1.92, 95% CI: 1.35 – 2.74, p<0.001) and disease behavior change (HR: 1.89, 95% CI: 1.27-2.81, p=0.002) were associated with time to first re-hospitalization in multiple Cox-regression analysis. Early hospitalization (within the year of diagnosis) was associated with age at onset (p=0.002), non-inflammatory disease behavior at diagnosis (OR: 2.67, p<0.001), internal fistulizing disease (OR: 2.02, p=0.04), need for immunosuppressives (OR: 1.74, p=0.018) and need for surgery/multiple surgeries (OR: 2.63, p=0.018 and OR: 2.54, p=0.005) during the disease course, and with need for surgery/multiple surgeries (p=0.018) also in multivariate analysis. Conclusions: Hospitalization and re-hospitalization rates are still high in this population-based cohort and early hospitalization was associated with clinically significant outcomes (need for immunosuppressives and surgery). Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factors for both hospitalization and re-hospitalization.