P0063 - Trends in In-Patient Mortality and Healthcare Resource Utilization in Inflammatory Bowel Disease With Cholangiocarcinoma: A Nationwide Inpatient Sample Database Analysis

Yashwitha Sai Pulakurthi, MBBS, MD¹, Medha Rajamanuri, MBBS², Sai Shanmukha Sreeram Pannala, MD³, Praneeth Reddy Keesari, MBBS³, Gautam Maddineni, MD⁴, Raed Atiyat, MD⁵, Shatha Nayef Elemian, MD¹, Muhammad Hussain, MD⁵, Mehul Shah, MD⁵, Theodore DaCosta Jr, MD^5
1Saint Michael's Medical Center, Newark, NJ; ²Southern Illinois University, Springfield, IL; ³Staten Island University Hospital, Northwell Health, Staten Island, NY; ⁴Florida State University, Cape Coral, FL; ⁵New York Medical College - Saint Michael's Medical Center, Newark, NJ

Introduction: Inflammatory bowel disease (IBD) is an autoimmune and a chronic inflammatory disease. Chronic inflammation increases the risk of various gastrointestinal cancers like Colorectal cancer, small bowel cancer, small intestinal lymphoma and Cholangiocarcinoma. IBD is linked to cholangiocarcinoma due to its close association with Primary Sclerosing Cholangitis (PSC). Here we aimed to study the trends in mortality and resource utilization in patients with cholangiocarcinoma & IBD from 2016 to 2020.

Methods: The National Inpatient Sample (NIS) 2016-2020 database was queried for patients hospitalized with a primary diagnosis of IBD and Cholangiocarcinoma using ICD-10 codes. Baseline characteristics, comorbidities, hospitalization trends, and in-hospital mortality were analyzed and adjusted to the year of admission using logistic regression

Results: Our study included a total of 3393 patients with IBD and existing cholangiocarcinoma over the period of 5 years. Out of them, 62.3% were male, majority belonged to white race (81.56%). In terms of comorbidities, 1.77% had obesity, 0.88% had Metabolic dysfunction associated Steatohepatitis (MASH). Around 14.14% of patients had Primary Sclerosing Cholangitis (PSC) and only 4.57% had gallstones. Cirrhosis was prevalent in 8.98% patients whereas hepatitis B and C were present only in 0.29 and 1.03% respectively.



Year adjusted mortality trends showed a general decline. In 2016, the mortality rate was 7.02%, which decreased to 5.07% in 2017. A further decline was seen in 2018 (3.05%), with a slight increase to 3.66% in 2019, although 2019 had higher number of admissions compared to the other years, and then 4.55% in 2020. Over 5 years, mean length of stay varied between 5.7 - 7.5 days. Mean total charges also varied significantly. Overall, an increasing trend of healthcare charges is evident with a mean total charge of $ 76,544.29 in 2016 and $ 98,278.57 in 2020. All data reported was statistically significant (p< 0.05).

Discussion: Our study highlights a declining trend of mortality rates among IBD patients with Cholangiocarcinoma from 2016 to 2020. This could be due to the advances in cancer therapeutics leading to improved survival as well as improvements in managing IBD patients leading to decreased inflammation/flares. However, increasing healthcare costs underscore the need for efficient resource allocation and targeted interventions.



Disclosures:


Yashwitha Sai Pulakurthi, MBBS, MD¹, Medha Rajamanuri, MBBS², Sai Shanmukha Sreeram Pannala, MD³, Praneeth Reddy Keesari, MBBS³, Gautam Maddineni, MD⁴, Raed Atiyat, MD⁵, Shatha Nayef Elemian, MD¹, Muhammad Hussain, MD⁵, Mehul Shah, MD⁵, Theodore DaCosta Jr, MD⁵. P0063 - Trends in In-Patient Mortality and Healthcare Resource Utilization in Inflammatory Bowel Disease With Cholangiocarcinoma: A Nationwide Inpatient Sample Database Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.