Inflammatory Bowel Disease Reoperation Rate Has Decreased Over Time If Corrected by Prevalence

Autores da FMUP

• Fernando José Magro Dias

  Autor

• Claudia Camila Rodrigues Pereira Dias

  Autor

Participantes de fora da FMUP

• Santiago, M
• Correia, L
• Portela, F
• Ministro, P
• Lago, P
• Trindade, E

Unidades de investigação

• Biomedicina

• Recursos Comuns

  

  Investigador

  Guilhermina Maria Da Silva Rêgo

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

INTRODUCTION: Despite the recent emergence of expensive biologic therapies, hospitalization and surgery remain important contributors for the overall costs of inflammatory bowel disease (IBD). In this study, we aimed to describe the burden of reoperations in patients with IBD by evaluating reoperation rates, charges, and risk factors over 16 years. METHODS: We performed a retrospective analysis of all hospital discharges, with focus on reoperations and with a primary diagnosis of IBD, in public hospitals between 2000 and 2015 in mainland Portugal from the Central Administration of the Health System's national registry. We collected data on patient, clinical, and healthcare charges. We used multivariate regressions to estimate the risk factors of IBD-related reoperations. RESULTS: We found that 5% of IBD-related hospitalizations were related to reoperations. The number of reoperations per year increased by approximately 200%. However, when corrected by the prevalence of the disease, IBD reoperation rates decreased. Mean IBD-related charges per hospitalization were 7,780 euro in 2000 and 10,592 euro in 2015, with total charges reaching 6.7 million euros by the end of the study. Risk factors for reoperation include urgent hospitalization, in patients with ulcerative colitis (odds ratio 1.94, 95% confidence interval 1.19-3.17,P= 0.008), and colic disease, in patients with Crohn's disease (odds ratio 1.57, 95% confidence interval 1.06-2.34,P= 0.025). DISCUSSION: To obtain an accurate scenario of reoperations among patients with IBD, it is mandatory to adjust the number of reoperations to the prevalence of the disease. Reoperation and its risk factors should be closely monitored to decrease the burden of IBD to the healthcare system.

Keywords

• Adult; Aged; Colitis, Ulcerative; Cost of Illness; Crohn Disease; Female; Health Care Costs; Hospitalization; Humans; Male; Middle Aged; Odds Ratio; Portugal; Prevalence; Reoperation; Retrospective Studies; Risk Factors; Young Adult; adult; aged; cost of illness; Crohn disease; economics; female; health care cost; hospitalization; human; male; middle aged; odds ratio; Portugal; prevalence; reoperation; retrospective study; risk factor; ulcerative colitis; young adult