title: Hospital-Acquired Conditions Are Associated with Worse Outcomes in Crohn's Disease-Related Hospitalizations.
abstract: Crohn's disease (CD) is a chronically relapsing condition that frequently requires hospitalization. In 2008, the Centers for Medicare and Medicaid Services selected ten conditions that were deemed healthcare-acquired conditions (HACs). Costs related to HACs are not reimbursed as they are considered to be preventable.
  
  
  
  To determine the prevalence and impact of HACs on hospital outcomes of hospitalized CD patients.
  
  
  
  This was a cross-sectional study using data from the Nationwide Inpatient Sample between 2007 and 2011 with an extended time frame between 2002 and 2013 to specifically evaluate the prevalence of HACs. CD-related hospitalizations and HACs were identified using International Classification of Diseases, Ninth revision, Clinical modification codes. The trend of HACs between 2002 and 2013 was assessed using a Cochran-Armitage test. Primary outcomes, including hospital mortality, length of stay, and hospital charges, were analyzed using univariate and multivariate analyses.
  
  
  
  The prevalence of HACs initially increased between 2002 and 2008, remained stable between 2008 and 2011, than significantly decreased from 2011 to 2013. CD patients with HACs had higher hospital mortality, prolonged LOS, and higher hospital charges compared to patients without HACs.
  
  
  
  The prevalence of HACs among hospitalized CD patients initially increased from 2002 to 2008; however, rates began to decrease between 2011 and 2013. In addition, HACs were associated with worse healthcare outcomes in hospitalized CD patients.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Obi
authors.affiliation: Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Hinton
authors.affiliation: Department of Medicine, The Ohio State University, Wexner Medical Center, Columbus, OH, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Sobotka
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Levine
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA.
authors.forename: Darwin
authors.initials: D
authors.lastname: Conwell
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University, Wexner Medical Center, 395 W. 12th Ave, 2nd Floor, Columbus, OH, 43210, USA. cheng.zhang@osumc.edu.
authors.forename: Cheng
authors.identifier: 0000-0002-5418-2968
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015897:Comorbidity; D003424:Crohn Disease / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
keywords: Crohn’s disease; Hospital-acquired conditions; Nationwide Inpatient Sample; Outcomes