Takeuchi Masato, Tomomasa Takeshi, Yasunaga Hideo, Horiguchi Hiromasa, Fushimi Kiyohide
Department of Pediatrics, University of Tokyo Hospital, Tokyo, Japan.
Department of Pediatrics, Kikkoman General Hospital, Chiba, Japan.
Pediatr Int. 2015 Jun;57(3):443-8. doi: 10.1111/ped.12547. Epub 2015 Feb 7.
Inflammatory bowel disease (IBD) - Crohn's disease (CD) and ulcerative colitis (UC) - are chronic inflammatory disorders of the intestine. Patients with IBD are at risk of hospitalization for disease exacerbation or IBD-associated complications. In the pediatric population, however, there are limited data on IBD hospitalizations. We therefore investigated the descriptive epidemiology of hospitalizations relevant to pediatric IBD.
The national inpatient claims database in Japan was searched for children (≤ 18 years old) with a diagnosis of IBD. The study period was 2007-2010. Data on demographic characteristics and descriptive statistics of the hospital course were extracted and analyzed.
A total of 3559 admissions of 2175 patients met the definition of pediatric IBD: there were 1999 admissions for CD and 1560 admissions for UC. Internists were responsible for patient care in 56.6% of admissions, followed by pediatricians (27.5%). Of 3559 admissions, unscheduled hospitalizations accounted for 79.7%, and 7.6% of hospitalizations were attributable to complications of IBD, including intestinal, extraintestinal and other manifestations. The median age at first admission was 16 years (IQR, 13-17 years), in both the CD and UC groups. Compared with UC patients, CD patients had a higher number of hospitalizations (P < 0.001), but hospital stay was shorter (median: 6 vs 16 days, P < 0.001). There were seven fatal cases of IBD, accounting for 0.32% in the present series, and sepsis was the cause in five.
This study provides a description of pediatric inpatients with IBD and their hospital course in Japan.
炎症性肠病（IBD）——克罗恩病（CD）和溃疡性结肠炎（UC）——是肠道的慢性炎症性疾病。IBD患者因疾病加重或IBD相关并发症而有住院风险。然而，在儿科人群中，关于IBD住院治疗的数据有限。因此，我们调查了与儿科IBD相关的住院治疗的描述性流行病学。
在日本全国住院患者索赔数据库中搜索诊断为IBD的儿童（≤18岁）。研究期间为2007 - 2010年。提取并分析了人口统计学特征数据以及住院病程的描述性统计数据。
2175例患者的3559次住院符合儿科IBD的定义：其中CD住院1999次，UC住院1560次。内科医生负责56.6%的住院患者护理，其次是儿科医生（27.5%）。在3559次住院中，非计划住院占79.7%，7.6%的住院归因于IBD的并发症，包括肠道、肠外和其他表现。CD组和UC组首次住院的中位年龄均为16岁（四分位间距，13 - 17岁）。与UC患者相比，CD患者的住院次数更多（P < 0.001），但住院时间更短（中位：6天对16天，P < 0.001）。有7例IBD死亡病例，占本系列的0.32%，其中5例死因是败血症。
本研究描述了日本儿科IBD住院患者及其住院病程。
