Temporal trend in inpatient mortality in inflammatory bowel disease-associated colorectal cancer vs non-inflammatory colorectal cancer: a nationwide retrospective study
| Autor: | Ikechukwu Achebe, Jennifer C Asotibe, Estefania Flores, Emmanuel Palomera-Tejeda, Ishaan Vohra, Vikram Kotwal, Chimezie Mbachi, Victor Udechukwu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer Population Subgroup analysis Inflammatory bowel disease Sepsis 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans education neoplasms Retrospective Studies education.field_of_study Inpatients Inpatient mortality business.industry Gastroenterology Retrospective cohort study Hepatology medicine.disease Inflammatory Bowel Diseases digestive system diseases 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Colitis Ulcerative business Colorectal Neoplasms |
| Zdroj: | International journal of colorectal disease. 36(4) |
| ISSN: | 1432-1262 |
| Popis: | Early detection and advancement in therapy have successfully achieved a steady decrease in colorectal cancer (CRC) mortality over the last two decades. On the other hand, studies investigating mortality trends in inflammatory bowel disease-associated CRC (IBD-CRC) are scarce and inconclusive. We conducted a retrospective analysis aiming to identify differences between inpatient mortality trends in IBD-CRC vs non-IBD-CRC and possible contributing factors. The National Inpatient Sample (NIS) database from 2006-2014 was queried to identify all patients admitted with a diagnosis of CRC. The main outcome was the prevalence and trend of mortality among IBD-CRC and non-IBD-CRC. The secondary outcome was the evaluation of predictors of inpatient mortality. A total of 1,190,759 weighted cases with the admission diagnosis of CRC were included in the study. Of which 10,997 (0.9%) had a co-diagnosis of IBD. The population with non-IBD-CRC had a statistically significant downward temporal trend in mortality (p < 0.001), while patients with IBD-CRC did not have any statistically significant temporal trend in inpatient mortality (p = 0.067). After subgroup analysis, patients with Crohn’s disease-CRC had an upward temporal trend in mortality (p = 0.183) compared to patients with ulcerative colitis-CRC with a downward trend in mortality (p = 0.001). Sepsis resulted to be a stronger predictor of mortality for CD-CRC, while VTE for UC-CRC. Multiples strategies established to prevent morbidity and mortality in CRC have been fruitful in non-IBD-CRC population, but have not been enough for IBD-CRC population to cause the same effect. Further strategies are needed to achieve a reduction in IBD-CRC mortality trend. |
| Databáze: | OpenAIRE |
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