Trends in hospitalization rates for inflammatory bowel disease in the United States

Background & Aims: This study examined trends in hospitalization and surgery rates for inflammatory bowel disease (IBD) in the United States over a 14-year period. Methods: We performed an analysis of secular trends of hospitalization and surgery rates from Crohn's disease (CD) and ulcerative colitis (UC) using the 1990 to 2003 National Hospital Discharge Survey data. The Spearman correlation coefficient was used to examine the association between calendar year and rates of hospitalization or bowel resection surgery. Results: From 1990 to 2003, the hospitalization rates for patients with a primary diagnosis of IBD per 100,000 people ranged from 9.3 to 17.1 for CD and 8.2 to 12.4 for UC, with a significant trend for increasing hospitalization rates for CD (rho = .83, P = .0002) but not UC (rho = .06, P = .83). The annual rates of bowel resection surgeries per 100,000 people ranged from 2.8 to 5.0 for CD and from 1.6 to 3.4 for UC, with no significant trend for CD (rho = .30, P = .30) or UC (rho = -.31, P = .28). As expected, there was a significant trend for shorter hospitalizations for both CD (rho = -.98, P < .0001) and UC (rho = -.87, P < .0001). However, total hospital days did not change significantly for either CD or UC. Conclusions: Despite advances in therapy, IBD hospitalization and surgery rates in the United States have not decreased since 1990. Rather, there has been a significant increase in hospitalizations for CD, with stable rates of bowel resection surgery for CD and hospitalization and surgery for UC.