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炎症性肠病不会影响急性心肌梗死患者的死亡率,但会增加其住院时间。

Inflammatory Bowel Disease Does Not Impact Mortality but Increases Length of Hospitalization in Patients with Acute Myocardial Infarction.

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Hub for Collaborative Medicine, Milwaukee, WI, 53226, USA.

Division of Gastroenterology and Liver Diseases, Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.

出版信息

Dig Dis Sci. 2021 Dec;66(12):4169-4177. doi: 10.1007/s10620-020-06818-x. Epub 2021 Jan 25.

Abstract

BACKGROUND AND AIM

Inflammatory bowel diseases (IBD) have been associated with increased risk of cardiovascular events. We aimed to investigate the outcomes of myocardial infarction (MI) in patients with IBD.

METHODS

We performed a cross-sectional study utilizing data from the Nationwide Inpatient Sample from the years 1998 to 2010. ICD-9-CM codes were used to identify patients with Crohn's disease (CD) (555.X), ulcerative colitis (UC) (556.X), and acute MI (410.X). Outcomes in patients with MI with and without IBD were compared. Univariate analysis was performed. Multivariate logistic regression was used to determine the effect of UC and CD on in-hospital MI mortality after adjusting for confounders.

RESULTS

A total of 2,629,161 MI, 3,607 UC and 3784 CD patients were analyzed. UC (odds ratio [OR], 1.12; 95% CI 0.98-1.29) and CD (OR 0.99; 95% CI 0.86-1.15) did not affect in-hospital mortality in patients with MI. There was no difference between in-hospital mortality in patients with MI with or without UC (7.75% vs. 7.05%; p = 0.25) or in patients with MI with or without CD (6.50% vs. 6.59%; p = 0.87). The length of stay (LOS) was higher in IBD patients and total charges were statistically higher in patients with UC as compared to non-IBD patients ($65,182 vs. $53,542; p < 0.001).

CONCLUSIONS

This study shows that IBD does not impact in-hospital mortality from MI. However, patients with MI with IBD have longer LOS. Patients with UC have higher total hospitalization charges than patients with MI without IBD. Further prospective studies are needed to assess the outcomes of MI in IBD patients.

摘要

背景与目的

炎症性肠病(IBD)与心血管事件风险增加相关。本研究旨在探讨 IBD 患者心肌梗死(MI)的结局。

方法

我们利用 1998 年至 2010 年全国住院患者样本进行了一项横断面研究。使用 ICD-9-CM 编码来识别克罗恩病(CD)(555.X)、溃疡性结肠炎(UC)(556.X)和急性 MI(410.X)患者。比较了 MI 伴或不伴 IBD 患者的结局。进行了单变量分析。采用多变量逻辑回归来确定 UC 和 CD 在调整混杂因素后对 MI 住院死亡率的影响。

结果

共分析了 2629161 例 MI、3607 例 UC 和 3784 例 CD 患者。UC(比值比 [OR],1.12;95%置信区间 [CI] 0.98-1.29)和 CD(OR 0.99;95% CI 0.86-1.15)并未影响 MI 患者的住院死亡率。MI 伴或不伴 UC 的患者(7.75%比 7.05%;p=0.25)或 MI 伴或不伴 CD 的患者(6.50%比 6.59%;p=0.87)之间的住院死亡率无差异。IBD 患者的住院时间(LOS)较长,UC 患者的总费用明显高于非 IBD 患者($65182 比 $53542;p<0.001)。

结论

本研究表明,IBD 并不影响 MI 的住院死亡率。然而,MI 伴 IBD 的患者 LOS 较长。与 MI 不伴 IBD 的患者相比,UC 患者的总住院费用更高。需要进一步的前瞻性研究来评估 IBD 患者 MI 的结局。

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