Choday Silpa, Jarvis Anne, Kim Peter, Chuang Keng-Yu, Vyas Neil
Department of Internal Medicine, Creighton University School of Health Science, Phoenix, AZ, USA.
Department of Gastroenterology, Valley wise Health Medical Center, Phoenix, AZ, USA.
J Investig Med. 2025 Mar;73(3):279-289. doi: 10.1177/10815589241300077. Epub 2025 Feb 3.
This study examined inflammatory bowel disease (IBD) trends over the last 10 years, including their nationwide patterns, and the outcomes of the utilization of total parental nutrition (TPN). Nationwide inpatient sample (NIS) database from 2010 to 2020, was used to identify IBD hospitalization and discharges and investigate outcomes, including in-hospital mortality and hospital resource utilization. The hospitalizations for IBD combining both Crohn's disease (CD) and ulcerative colitis (UC) initially noted a rising trend until 2016 followed by a decreasing trend with statistical significance ( < 0.001). A decreasing trend in TPN utilization in CD dropped from 6.2 to 5.4% ( = 0.07). The prevalence of malnutrition in CD cases significantly increased from 11.6 to 16.6% ( < 0.001), and the use of TPN in malnutrition cases decreased from 25.0 to 20.0% with statistical significance ( = 0.002). TPN in UC cases also exhibited a downward trend, declining from 5.3 to 3.1% with statistical significance ( < 0.001). However, there was a noteworthy increase in malnutrition rates, rising from 13.5 to 17.3% ( = 0.087). Similarly, the utilization of TPN in malnutrition cases among UC cases displayed a significant decrease from 19.9 to 11.3% ( < 0.001). The combined use of TPN in IBD showed a decreased trend from 5.9 to 4.3% with statistical significance ( < 0.001). There is a decline in the trend in TPN usage in both CD and UC. The hospital costs and malnutrition trend has increased, while the inpatient mortality, length of stay, and TPN use decreased over the year.
本研究调查了过去10年炎症性肠病(IBD)的趋势,包括其全国范围内的发病模式,以及全胃肠外营养(TPN)的使用结果。利用2010年至2020年的全国住院患者样本(NIS)数据库,确定IBD住院和出院情况,并调查包括住院死亡率和医院资源利用在内的结果。IBD(包括克罗恩病(CD)和溃疡性结肠炎(UC))的住院人数最初呈上升趋势,直至2016年,随后呈下降趋势,具有统计学意义(<0.001)。CD患者中TPN的使用呈下降趋势,从6.2%降至5.4%(=0.07)。CD患者中营养不良的患病率从11.6%显著增加至16.6%(<0.001),营养不良患者中TPN的使用从25.0%降至20.0%,具有统计学意义(=0.002)。UC患者中TPN也呈下降趋势,从5.3%降至3.1%,具有统计学意义(<0.001)。然而,营养不良率有显著上升,从13.5%升至17.3%(=0.087)。同样,UC患者中营养不良病例的TPN使用从19.9%显著降至11.3%(<0.001)。IBD患者中TPN的联合使用呈下降趋势,从5.9%降至4.3%,具有统计学意义(<0.001)。CD和UC患者中TPN的使用均呈下降趋势。医院费用和营养不良趋势有所增加,而住院死亡率、住院时间和TPN使用在这几年有所下降。