P2560 - Dynamic Trends in Emergency Department Visits and Procedure Utilization for Patients With Inflammatory Bowel Disease (IBD) in the United States: A NEDS-Based Analysis (2012-2021)
Ali A. Aalam, MBBS, MD1, Nofel Iftikhar, 1, Naueen A. Chaudhry, MD, MS.1, Tomas Potlach, BS2, Ellen M. Zimmermann, MD1 1University of Florida, Gainesville, FL; 2University of Florida College of Medicine, Miami, FL
Introduction: The emergency department (ED) is vital for addressing acute symptoms and complications in IBD patients. Our study aims to analyze ED trends, including IBD-related visits and subsequent GI procedures, informing resource allocation and improving health policies.
Methods: This study utilized a cross-sectional temporal analysis, performed using data from the Nationwide Emergency Department Sample (NEDS). The study analyzed 1.3 billion ED visits from 2012 to 2021 across 39 states. It included patients with IBD, diagnosed using ICD 9-10 codes, with or without major clinical complications or clinical comorbidities. The proportion of each GI procedure performed yearly was obtained by dividing the number of specific procedures each year by the total sum of specific procedures over the decade. An ordinary least squares (OLS) regression model analyzed trends in the usage of diagnostic procedures and surgeries from 2012 to 2021 and predicted their utilization for IBD patients from 2022 to 2027.
Results: From 2012 to 2021, the mean patient age was 41 (range 0-90), with a female majority (55:45). The population was mainly White (59.4%), followed by African Americans (17.3%), Hispanics (13.1%), Asians/Pacific Islanders (6.5%) and Native Americans (2.5%). During this period, 139,770 IBD patients were admitted as inpatients from ED visits. The use of colonoscopy with biopsy increased from 6.4% to 12.5%, and upper GI endoscopy with biopsy rose from 6.8% to 12.4% from 2012 to 2021. Also, colorectal resections decreased from 17.6% to 12.7%, colostomies increased from 9.2% to 15.6%, small bowel resections rose from 6.6% to 21.32% and ileostomies from 0.9% to 15%. An OLS regression model showed a significant positive correlation (p< 0.05, R² = 0.995, 1.00) and predicted more ED patients with IBD undergoing diagnostic procedures from 2022 to 2027. The model showed a positive correlation (p< 0.05, R2 = 1.00, 0.99), predicting a slight increase in small bowel resections and a doubling of ileostomies from 2022 to 2027
Discussion: Our data show that most surgical and endocsopic procedures increased over a decade and modeling predicted their increased use in the future. This data should aid healthcare planning and policy development. Our data would support initiatives to improve access to outpatient care for IBD patients and promote adherence to maintenance therapy. This could reduce ED strain and improve patient outcomes.
Figure: Fig (1a): Seaborn bar plot showing the number of ED patients with Inflammatory Bowel Disease undergoing GI Diagnostic Procedures during ED visit including Colonoscopy with biopsy and Upper GI Endoscopy with biopsy. Fig (1b): Seaborn bar plot showing the number of ED patients with Inflammatory Bowel Disease undergoing Small Bowel Resection, Colorectal Bowel Resection, Ileostomy, either permanent or temporary, and Colostomy during an ED visit.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Ali Aalam indicated no relevant financial relationships.
Nofel Iftikhar indicated no relevant financial relationships.
Naueen Chaudhry indicated no relevant financial relationships.
Tomas Potlach indicated no relevant financial relationships.
Ellen Zimmermann indicated no relevant financial relationships.
Ali A. Aalam, MBBS, MD1, Nofel Iftikhar, 1, Naueen A. Chaudhry, MD, MS.1, Tomas Potlach, BS2, Ellen M. Zimmermann, MD1. P2560 - Dynamic Trends in Emergency Department Visits and Procedure Utilization for Patients With Inflammatory Bowel Disease (IBD) in the United States: A NEDS-Based Analysis (2012-2021), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
