Background: Inflammatory bowel disease (IBD) exacerbations may lead to prolonged and complicated hospitalizations, that may affect the quality of life of the patients, as well as health costs. The aim of the study was to describe characteristics of exacerbation-related hospital admissions and to identify predictors for poor outcome of hospitalizations in children with IBD.
Methods: We performed a retrospective analysis of all hospital admissions of children due to IBD exacerbation, during the years 2000-2017. Demographic and disease characteristics were documented, as well as admission course. Poor outcome of hospitalizations was defined as prolonged hospitalization (7 days and longer) or operation during hospitalization.
Results: We included a total of 181 admissions in 78 children with a median (IQR) age of 12.35 (9.13-14.30) years. Among them, 53 (67.9%) had Crohn`s disease and 25 (32.1%) had ulcerative colitis. Of all admissions, 43 (23.8%) were prolonged. In a multivariate analysis adjusted for age, gender and disease type, severe disease activity at admission (OR=3.33, P=0.013), lower weight percentile (OR=1.02, P=0.009), lower albumin (OR=1.08, P=0.022), treatment with antibiotics (OR=5.03, P=0.001), blood transfusion (OR=8.03, P=0.003) and need for endoscopy (OR=2.73, P=0.027) and imaging during admission (OR=3.61, P=0.001) were predictors for prolonged hospitalizations. Operation was performed in 18 admissions. Penetrating (OR=7.73, P=0.019) and stricturing disease (OR=12.38, P<0.001) were predictors for operation during hospitalization.
Conclusions: We defined predictors for prolonged hospitalizations and need for operation during hospitalization in children with IBD. Early recognition of children at risk for poor outcome during hospitalizations may improve the management of these children.
