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广泛性焦虑症住院患者的炎症性肠病结局

Outcomes of Inflammatory Bowel Disease in Hospitalized Patients With Generalized Anxiety Disorder.

作者信息

Kaye Alexander J, Patel Shivani J, Meyers Sarah R, Ahlawat Sushil

机构信息

Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA.

Psychiatry, Rutgers University Robert Wood Johnson Medical School, Piscataway, USA.

出版信息

Cureus. 2022 Aug 3;14(8):e27656. doi: 10.7759/cureus.27656. eCollection 2022 Aug.

Abstract

Background The development of inflammatory bowel disease (IBD), which encompasses ulcerative colitis and Crohn's disease, is multifactorial. Stress from anxiety is a risk factor for IBD. Generalized anxiety disorder (GAD) is twice as likely in IBD patients. This study explores the outcomes of patients hospitalized for IBD with comorbid GAD. Methods A retrospective analysis utilizing the 2014 USA National Inpatient Sample database was performed to assess the outcomes of hospitalized IBD patients with and without GAD. The outcomes analyzed were sepsis, acute hepatic failure, hypotension/shock, acute respiratory failure, acute deep vein thrombosis, acute renal failure, intestinal obstruction, myocardial infarction, ileus, inpatient mortality, colectomy, intestinal abscess, intestinal perforation, and megacolon. A multivariate logistic regression analysis was employed to explore whether GAD is a risk factor for these outcomes. Results Among 28,173 IBD hospitalized patients in the study, GAD was a comorbid diagnosis in 3,400 of those patients. IBD patients with coexisting GAD were found to be at increased risk for acute hepatic failure (adjusted odds ratio (aOR) 1.80, p = 0.006), sepsis (aOR 1.33, p < 0.001), acute respiratory failure (aOR 1.24, p = 0.018), inpatient mortality (aOR 1.87, p < 0.001), intestinal abscess (aOR 2.35, p = 0.013), and intestinal perforation (aOR 1.44, p = 0.019). The aORs for the remaining outcomes were not statistically significant. Conclusions In hospitalized IBD patients, GAD is a risk factor for sepsis, acute hepatic failure, acute respiratory failure, intestinal abscess, intestinal perforation, and inpatient mortality. IBD and GAD are becoming increasingly common, which will likely lead to a larger number of complications among inpatients with these comorbidities.

摘要

背景

炎症性肠病(IBD)包括溃疡性结肠炎和克罗恩病,其发病是多因素的。焦虑引起的压力是IBD的一个风险因素。IBD患者患广泛性焦虑障碍(GAD)的可能性是正常人的两倍。本研究探讨了合并GAD的IBD住院患者的治疗结果。方法:利用2014年美国国家住院患者样本数据库进行回顾性分析,以评估有或无GAD的IBD住院患者的治疗结果。分析的结果包括败血症、急性肝衰竭、低血压/休克、急性呼吸衰竭、急性深静脉血栓形成、急性肾衰竭、肠梗阻、心肌梗死、肠梗阻、住院死亡率、结肠切除术、肠脓肿、肠穿孔和巨结肠。采用多因素逻辑回归分析探讨GAD是否是这些结果的风险因素。结果:在该研究的28173例IBD住院患者中,3400例患者合并GAD。发现合并GAD的IBD患者发生急性肝衰竭(校正比值比[aOR]1.80,p = 0.006)、败血症(aOR 1.33,p < 0.001)、急性呼吸衰竭(aOR 1.24,p = 0.0

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