Sepsis in hospitalizations with short bowel syndrome: A 10-year analysis from the national inpatient sample database

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Conference Proceeding

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Am J Gastroenterol


Introduction: There appears to be a known risk of sepsis in hospitalizations with short-bowel syndrome (SBS). This is relatively well-studied in children, however, the data in adult hospitalizations with SBS complicated by sepsis is limited. Methods: We conducted a retrospective study using the national inpatient sample (NIS). We identified all patients with a primary or secondary discharge diagnosis of SBS during the years 2005 to 2014. We then identified hospitalizations complicated by sepsis. We then stratified the data into two groups: 1) SBS-sepsis and 2) SBS-no-sepsis to compare the baseline characteristics and outcomes. We also created multivariate hierarchical models to determine the predictors of mortality in the SBS hospitalizations complicated by sepsis. Results: Of 307,376 SBS hospitalizations, 53,550 hospitalizations (17.4%) were found to be complicated by sepsis. The prevalence of such complicated hospitalizations showed an upward trend from 2005 to 2014 (Figure 1). The age group 35-49 years showed the highest hospitalization rate with females were more affected than males (67.2% vs 32.8%, P<0.0001) (Table 1). Approximately 19.3% hospitalizations were emergent/urgent whereas 80.7% were elective (P<0.0001) (Table 1). Association of intestinal transplantation appeared to be higher with SBS hospitalizations complicated by sepsis as compared to those without sepsis (0.33% vs 0.22%, P<0.0001). The inpatient all-cause mortality rate was significantly higher in SBS hospitalizations complicated by sepsis than those without sepsis (8.5% vs 1.4%, P< 0.0001) (Table 1). Similarly, the mean length of stay (LOS) was significantly higher in SBS-sepsis cohort (16.1±0.4 days vs 7.7±0.1 days). In SBS-sepsis cohort, age group 18-44 years had six times higher risk of all-cause mortality than age group .5 85 years (OR 5.85; CI 3.95 - 8.66, P<0.0001). This risk appeared to decrease with increase in age. Women had higher all-cause mortality as compared to men (OR 1.18; CI 1.02 - 1.38, P=0.03), and White race was noted to have an all-cause mortality risk 1.65 times greater than as compared to other races (OR 1.65; CI 1.17 - 2.33, P=0.005). Conclusion: There was a continuous rise in SBS hospitalizations complicated by sepsis. SBS hospitalizations complicated by sepsis have a higher all-cause mortality rate and longer length of stay when compared to those without sepsis. All-cause mortality rate appeared to be higher in women and younger SBS with sepsis..

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