Characterizing Post-Hospitalization Outcomes and Disparities in Inflammatory Bowel Disease at a Multi-Hospital Academic Center

Document Type

Conference Proceeding

Publication Date

12-1-2025

Publication Title

Am J Gastroenterol

Keywords

Gastroenterology & Hepatology

Abstract

Background: Inflammatory bowel disease (ISBD) is a chronic condition that may result in hospitalization for disease flares and complications which contribute substantially to healthcare costs and patient burden. Although the introduction of biologic therapies has led to a decline in repeat hospitalization rates over time, disparities in outcomes persist. We aimed to characterize the post-hospitalization outcomes for IBD patients admitted to a large, urban academic center with multiple hospitals and sought to identify potential factors associated with disparities in IBD outcomes to inform potential future interventions to improve outcomes in this cohort. Methods: We retrospectively identified consecutive adult admissions at a large academic center with multiple campuses for Crohn’s disease (CD) or ulcerative colitis (UC) between September 1, 2022, and August 30, 2024. Demographics, IBD therapies, and laboratory markers were abstracted. Primary outcomes were repeat hospital admission or ED visit within 12 months; secondary outcomes included time to follow up in GI clinic. Bivariate analyses and regression models (logistic, Poisson, and Cox proportional hazards) were used to assess associations between demographic/clinical variables and outcomes. Results: 227 patients met inclusion criteria (median age 42 years; 52% women; 29% Black, 60% White); 63% had CD, 37% UC; 15% current smokers; median zipcode income $56,357. Median length of stay was 4 days; 12% initiated a biologic agent during hospitalization. 12% were readmitted within 12 months. 38% had ED visit within 12 months. Black race was significantly associated with increased ED utilization (IRR 1.67, P < 0.01), while administration of biologic therapy during admission was protective (IRR 0.36, P < 0.001). No significant associations were observed with sex, median income, IBD subtype, or smoking/alcohol use. Conclusions: In this diverse IBD cohort, Black race was independently associated with higher ED utilization following hospitalization after adjusting for other factors, underscoring persistent disparities in post-discharge care. Administration of a biologic agent during the initial hospitalization was associated with improved outcomes, suggesting that early intervention during a flare may positively alter disease trajectory and reduce acute care utilization. These findings underscore the importance of both timely therapeutic intervention and targeted, equity-focused support systems to improve long-term outcomes in IBD.

Volume

120

Issue

12S

First Page

S22

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