title: Effect of the Diagnosis of Inflammatory Bowel Disease on Risk-Adjusted Mortality in Hospitalized Patients with Acute Myocardial Infarction, Congestive Heart Failure and Pneumonia.
abstract: BACKGROUND
  Measurement of mortality in patients with acute myocardial infarction (AMI), congestive heart failure (CHF) and pneumonia (PN) is a high priority since these are common reasons for hospitalization. However, mortality in patients with inflammatory bowel disease (IBD) that are hospitalized for these common medical conditions is unknown.
  
  
  METHODS
  A retrospective review of the 2005-2011 National Inpatient Sample (NIS), (approximately a 20% sample of discharges from community hospitals) was performed. A dataset for all patients with ICD-9-CM codes for primary diagnosis of acute myocardial infarction, pneumonia or congestive heart failure with a co-diagnosis of IBD, Crohn's disease (CD) or ulcerative colitis (UC). 1:3 propensity score matching between patients with co-diagnosed disease vs. controls was performed. Continuous variables were compared between IBD and controls. Categorical variables were reported as frequency (percentage) and analyzed by Chi-square tests or Fisher's exact test for co-diagnosed disease vs. control comparisons. Propensity scores were computed through multivariable logistic regression accounting for demographic and hospital factors. In-hospital mortality between the groups was compared.
  
  
  RESULTS
  Patients with IBD, CD and UC had improved survival after AMI compared to controls. 94/2280 (4.1%) of patients with IBD and AMI died, compared to 251/5460 (5.5%) of controls, p = 0.01. This represents a 25% improved survival in IBD patients that were hospitalized with AMI. There was a 34% improved survival in patients with CD and AMI. There was a trend toward worsening survival in patients with IBD and CHF. Patients with CD and PN had improved survival compared to controls. 87/3362 (2.59%) patients with CD and PN died, compared to 428/10076 (4.25%) of controls, p < .0001. This represents a 39% improved survival in patients with CD that are hospitalized for PN.
  
  
  CONCLUSIONS
  IBD confers a survival benefit for patients hospitalized with AMI. A diagnosis of CD benefits survival in patients that are hospitalized with PN.
authors.affiliation: Center for the Study of Complex Diseases, NorthShore University HealthSystem, Evaston, Illinois, United States of America.
authors.forename: Eli D
authors.initials: ED
authors.lastname: Ehrenpreis
authors.affiliation: Center for the Study of Complex Diseases, NorthShore University HealthSystem, Evaston, Illinois, United States of America.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Center for the Study of Complex Diseases, NorthShore University HealthSystem, Evaston, Illinois, United States of America.
authors.forename: Aimee
authors.initials: A
authors.lastname: Alexoff
authors.affiliation: Center for the Study of Complex Diseases, NorthShore University HealthSystem, Evaston, Illinois, United States of America.
authors.forename: Constantine
authors.initials: C
authors.lastname: Melitas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D011014:Pneumonia / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D012189:Retrospective Studies; D020379:Risk Adjustment; D055815:Young Adult