Hospitalization Rates for Crohnʼs Disease Patients in Olmsted County, Minnesota, in the Pre-Biologic Era

Abstract

Purpose: Inpatient hospitalization is a major component of health care resource consumption for patients (pts) with Crohn's disease (CD). However, there are limited data on annual hospitalization rates for CD pts not treated with anti-tumor necrosis factor (TNF) therapy. We sought to estimate the historical hospitalization rates for a population-based cohort of CD pts from Olmsted County, Minnesota, in the pre-biologic era. Methods: Previously identified county residents diagnosed with CD between January 1970 and June 1997 were included in the analysis and were followed until June 1997. Medical records were abstracted for all CD-related hospitalizations, which were classified as surgical or medical. For pts who were hospitalized at the time of CD diagnosis (N = 73), the initial hospitalization was not included in estimates. Crude incidence rates over the entire follow-up period and the first year after diagnosis of CD were calculated. Results: A total of 211 patients with CD were included and were followed for 2,247 pt-yrs. Median age at diagnosis was 29 years (range, 8.4–88.5), and 51% were female. One hundred twenty pts (56.9%) had at least one CD-related hospitalization (median per pt, 2 [range, 1–22]). Excluding the 73 initial hospitalizations at time of diagnosis, the patients experienced 437 hospitalizations (194 per 1000 pt-yrs), including 165 hospitalizations with inpatient surgeries (73 per 1000 pt-yrs). Conclusion: Before 1998, when biologics such as TNF antagonists were not yet available, the crude rate of CD-related hospitalizations was relatively high. The crude hospitalization rate in the first yr after CD diagnosis was over twice as high as the overall rate. These data provide a baseline reference for comparison to gauge the impact of anti-TNF therapy on hospitalization rates in patients with CD. Therapies that reduce the hospitalization risk may provide substantial benefits to patients with CD.Table. CD: Related Hospitalizations in Olmsted County, 1970–97