title: Risk of comorbidities on postoperative outcomes in patients with inflammatory bowel disease.
abstract: BACKGROUND
  The effect of comorbidities on postoperative outcomes in patients with inflammatory bowel disease (IBD) has not been explored adequately. We evaluated the prevalence of comorbidities and their effect on postoperative outcomes after an IBD-related operation.
  
  
  METHODS
  The Nationwide Inpatient Sample database was used to identify 35 588 patients with IBD who underwent an IBD-related operation from January 1, 1995, through December 31, 2005. The presence of comorbid illness was assessed using the Elixhauser index. Multiple logistic regression analysis was performed to evaluate the effect of comorbidities on mortality rate after adjusting for age, sex, race, health insurance status, and admission type. Linear regression models were used to evaluate health care resource use.
  
  
  RESULTS
  Postoperative mortality was 1.9%. As the number of comorbidities increased (ie, 0, 1, 2, or ≥3), postoperative mortality increased (0.4%, 1.5%, 3.3%, and 7.9%, respectively). Congestive heart failure (odds ratio, 3.50 [95% confidence interval, 2.63-4.62]), liver disease (3.15 [2.00-4.97]), thromboembolic disease (4.19 [3.37-5.21]), and renal disease (8.74 [5.44-14.05]) were associated with a significant increase in mortality rate. Comorbidities associated with an increased risk of mortality also were associated with a significant increase in length of stay and hospital charges.
  
  
  CONCLUSIONS
  Comorbidities were common in patients with IBD and they significantly increased the risk of postoperative mortality and health care use in patients with IBD.
authors.affiliation: Inflammatory Bowel Disease Clinic, Canada. ggkaplan@ucalgary.ca
authors.forename: Gilaad G
authors.initials: GG
authors.lastname: Kaplan
authors.forename: James
authors.initials: J
authors.lastname: Hubbard
authors.forename: Remo
authors.initials: R
authors.lastname: Panaccione
authors.forename: Abdel Aziz M
authors.initials: AA
authors.lastname: Shaheen
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Nguyen
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.forename: Subrata
authors.initials: S
authors.lastname: Ghosh
authors.forename: Robert P
authors.initials: RP
authors.lastname: Myers
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D012306:Risk; D012307:Risk Factors; D016896:Treatment Outcome