Comorbid IBD and Chronic Depression Increase Risk for Shock and Other Negative Outcomes

Patients with inflammatory bowel disease (IBD) and chronic depression have an increased risk for shock, as well as greater hospital costs and length of stay, compared against patients with IBD and no chronic depression, according to research presented at the American College of Gastroenterology (ACG) 2021 Annual Meeting, held from October 22 to 27, 2021, in Las Vegas, Nevada and virtually.

This observational, retrospective study assessed outcomes of patients admitted for IBD with an associated diagnosis of chronic depression from the National (Nationwide) Inpatient Sample for 2016 and 2017. International Classification of Diseases–Clinical Modification (ICD-CM) diagnostic codes were used to identify all patients with a principal diagnosis of IBD as well as those with chronic depression.

Inpatient mortality odds among patients with IBD and depression vs those in patients with IBD and no depression were the primary outcome. Morbidity measures and inpatient resource use were secondary outcomes. The study authors adjusted for sex, age, Charlson Comorbidity Index score, income in patient zip code, and hospital region, location, size, and teaching status with use of multivariate regression analysis.

A total of 205,074 patients who were admitted for IBD were identified, of whom 670 (0.33%) had an associated diagnosis of chronic depression. Patients with depression had a mean age of 41.1 years (54.1% women), and those without depression had a mean age of 42.8 years (45.9% women).

Patients with IBD and depression had an adjusted odds ratio (aOR) for increased mortality of 3.63, although it did not reach statistical significance. Among morbidity measures, patients with IBD and depression had increased odds for shock (aOR, 4.65; P <.01), followed by multi-organ failure (aOR, 1.53) and sepsis (aOR, 1.52). Patients with IBD and depression also had increased additional adjusted hospitalization costs, hospitalization charges, and length of hospitalization, compared against participants with IBD and without chronic depression.

“This study highlights the importance of routine assessment and treatment of clinical depression as a health maintenance measure in patients with IBD,” commented the researchers. “However, taking disease severity into account will be of paramount importance in future studies. Therefore, the inclusion of mental health providers to the IBD multidisciplinary care team is of paramount importance,” they concluded.

Reference

Kroner PT, Kwon J, Palacios P, et al. Chronic depression is associated with negative outcomes in patients admitted for inflammatory bowel disease. Presented at: ACG 2021 Annual Meeting; October 22-27, 2021; Las Vegas, NV and virtual. Abstract P0507.