Mohamed Tausif Siddiqui, MD1, Amandeep Singh, MD2, Mohammad Bilal, MD3, Donald F. Kirby, MD2
1New York Medical College, Valhalla, NY; 2Cleveland Clinic Foundation, Cleveland, OH; 3The University of Texas Medical Branch, Galveston, TX
Introduction: Multiple intestinal surgeries or massive resection often lead to short bowel syndrome (SBS) which is associated with frequent hospitalizations and has high morbidly and resource utilization. But, data on these outcomes are lacking. We aimed to assess the trends of SBS-related hospitalizations, mortality and costs associated with these hospitalizations.
Methods: We used United States' Nationwide In-patient Sample (NIS) Database for 10 years beginning from 2005 to 2014. SBS does not have a unique International Classification of Diseases 9th Clinical Modification (ICD-9-CM) Code, therefore, we used a previously described methodology which identified SBS via combination of two diagnostic ICD-9 codes. Any hospital discharge with the presence of ICD9: "579.3: Other and unspecified postsurgical non-absorption" and ICD9: "99.15: Parenteral infusion of concentrated nutrition substances" was labeled in our study as an SBS case. We excluded the cases with missing information of in-hospital mortality (N=40).
Results: A total of 53,040 hospitalizations associated with SBS were included in the final analysis. Our study population consisted of 65% females and 78% were Caucasians. Ages 51-56 and >65 were the most prevalent age groups (37% and 30%, respectively) and Medicare the major payer in the study populations (Table 1). Overall, SBS-related hospitalizations have increased from 4037 in 2005 to 6265 in 2014. But, all cause in-hospital mortality has decreased from 40/1000 hospitalizations in 2005 to 29/1000 hospitalizations in 2014. Most common concurrent diagnoses were protein-calorie malnutrition (N=13063, 24.6%), hypertension (N=11450, 21.5%), hypokalemia (N=11334 21.3%), acute kidney injury (N=10611, 20.01%) and dehydration (N=9649, 18.1%). A total 15,761 (29.7%) patients received packed red cell transfusion. Mean length of stay for SBS-related hospitalization was 14.7 days and average hospital cost was US$ 31,921.
Discussion: Our results suggests that SBS-hospitalizations have increased by 54% in the last decade but in-hospital mortality associated with SBS has decreased by 27.5%. Further studies are required to assess the causes related to increased hospitalizations and improved mortality outcomes.
Citation: Mohamed Tausif Siddiqui, MD; Amandeep Singh, MD; Mohammad Bilal, MD; Donald F. Kirby, MD. P1255 - EPIDEMIOLOGY AND HEALTHCARE RESOURCE UTILIZATION ASSOCIATED WITH ADULTS HOSPITALIZED WITH SHORT BOWEL SYNDROME. Program No. P1255. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.