疫情早期炎症性肠病患者新冠病毒感染的医院相关结局预测因素：一项全国住院患者数据库调查
Predictors of Hospital-related Outcomes of COVID-19 Infection in Patients With Inflammatory Bowel Disease in the Early Pandemic Phase: A Nationwide Inpatient Database Survey.
作者信息
Naseem Khadija, Sohail Abdullah, Quang Nguyen Vu, Khan Ahmad, Cooper Gregory, Lashner Bret, Katz Jeffry, Cominelli Fabio, Regueiro Miguel, Mansoor Emad
机构信息
Cleveland Clinic Foundation, Cleveland, OH, USA.
The University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
出版信息
Inflamm Bowel Dis. 2024 Aug 1;30(8):1334-1344. doi: 10.1093/ibd/izad200.
BACKGROUND
Patients with inflammatory bowel disease (IBD) are at higher risk for severe COVID-19 infection. However, most studies are single-center, and nationwide data in the United States are lacking. This study aimed to investigate hospital-related outcomes and predictors of these outcomes in patients with IBD and COVID-19 infection.
METHODS
The National Inpatient Sample and National Readmission database were queried for all the patient hospitalizations with IBD with concurrent COVID-19 in the study group and non-COVID-19 related hospitalizations in the control group. For patients under 18 years, elective and trauma-related hospitalizations were excluded. Primary outcomes included mortality, septic shock, mechanical ventilation, and intensive care utilization. Secondary outcomes included length of stay and total hospitalization costs.
RESULTS
From this query, 8865 adult patients with IBD and COVID-19 were identified. These patients were relatively older (62.8 vs 57.7 years, P < .01), and the majority were females (52.1% with COVID-19 vs 55.2% without COVID-19). Patients with IBD and COVID-19 had higher mortality (12.24% vs 2.55%; P < .01), increased incidence of septic shock (7.9% vs 4.4%; P < .01), mechanical ventilation (11.5% vs 3.7%; P < .01), and intensive care utilization (12% vs 4.6%; P < .01). These patients also had higher mean length of stay (8.28 days vs 5.47 days; P < .01) and total hospitalization costs ($21 390 vs $16 468; P < .01) than those without COVID-19 infection.
CONCLUSIONS
Patients with IBD and COVID-19 have worse outcomes, with a higher incidence of severe COVID-19 disease, leading to higher mortality rates, longer lengths of stay, and increased total hospitalization costs. Encouraging preventive health measures and treating promptly with advanced COVID-19 therapies may improve outcomes and decrease the healthcare burden.
背景
炎症性肠病（IBD）患者发生重症新型冠状病毒肺炎（COVID-19）感染的风险更高。然而，大多数研究为单中心研究，美国缺乏全国性数据。本研究旨在调查IBD合并COVID-19感染患者的医院相关结局及这些结局的预测因素。
方法
在全国住院患者样本数据库和全国再入院数据库中查询研究组中所有IBD合并COVID-19的住院患者以及对照组中与COVID-19无关的住院患者。对于18岁以下患者，排除择期和创伤相关住院病例。主要结局包括死亡率、感染性休克、机械通气和重症监护使用率。次要结局包括住院时间和总住院费用。
结果
通过此次查询，共识别出8865例IBD合并COVID-19的成年患者。这些患者年龄相对较大（62.8岁对57.7岁，P<0.01），且大多数为女性（COVID-19患者中占52.1%，非COVID-19患者中占55.2%）。IBD合并COVID-19的患者死亡率更高（12.24%对2.55%；P<0.01），感染性休克发生率增加（7.9%对4.4%；P<0.01），机械通气率增加（11.5%对3.7%；P<0.01），重症监护使用率增加（12%对4.6%；P<0.01）。与未感染COVID-19的患者相比，这些患者的平均住院时间也更长（8.28天对5.47天；P<0.01），总住院费用更高（21390美元对16468美元；P<0.01）。
结论
IBD合并COVID-19的患者结局更差，重症COVID-19疾病的发生率更高，导致死亡率更高、住院时间更长且总住院费用增加。鼓励采取预防性健康措施并及时采用先进的COVID-19治疗方法可能会改善结局并减轻医疗负担。
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