Amjad Shaikh, BA, Preet Patel, BA, James Huynh, BA, Pavan Patel, MD, Sushil Ahlawat, MD
Rutgers New Jersey Medical School, Newark, NJ
Introduction: Introductions: The effects of HIV status on inflammatory bowel disease (IBD) has been described in the literature but has been limited in cohort size. Here, we examine data from patients with IBD and HIV in the Nationwide Inpatient Sample database over a 7-year period.
Methods: Data between 2008 and 2014 from the Nationwide Inpatient Sample database was extracted. Inclusion criteria for both groups included patients with a primary diagnosis of either Crohn’s disease or Ulcerative colitis using International Classification of Diseases, 9th Revision codes. Exclusion criteria included all patients less than 18 years of age. Test group consisted of patients with a primary diagnosis of Crohn’s disease or Ulcerative colitis and a concurrent diagnosis of HIV. In hospital mortality and complications including anemia, malabsorption, malnutrition, stenosis, obstruction, fistulas, abscesses, ulcers, perforations, and hemorrhage were compared between the two groups. Univariate and multivariate analyses were used to generate odds ratios. Multivariate analysis included age, gender, race, and calculated Elixhauser scores. Elixhauser Comorbidity scores predicting mortality and readmission were calculated based on weighted scores from 29 different comorbidities. Scores were compared between the two groups using univariate analysis.
Results: There were a total of 121835 patients with IBD and no HIV and 475 patients with IBD and HIV for hospitals in the United States between 2008 and 2014. There was no significant difference in hospital mortality between the two groups on univariate analysis (OR 0.5161, p = 0.5092). Of the complications studied, there was a significant difference for obstruction (OR 0.3447, p < 0.0001), ulceration (OR 1.97, p =0.0063), and hemorrhage (OR 1.75, p = 0.0001) on univariate analysis. For the multivariate analysis, HIV status has a significant effect on anemia (OR 0.291, p = < 0.001), malnutrition (OR 0.3, p = < 0.001), obstruction (OR 0.411, p = < 0.001), and hemorrhage (OR 1.47, p = < 0.001).
Discussion: HIV status does not seem to have a significant effect on mortality, but appears to be protective against obstruction, anemia, and malnutrition. We suspect the immunocompromised status of HIV patients may lead to fewer bouts of acute inflammation, reducing the rates of complications. It may also be of interest to compare rates of procedures and interventions between the two groups to further explore potential differences.
Citation: Amjad Shaikh, BA, Preet Patel, BA, James Huynh, BA, Pavan Patel, MD, Sushil Ahlawat, MD. P0458 - THE EFFECTS OF HIV STATUS ON COMPLICATIONS AND OUTCOMES IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: AN ANALYSIS USING THE NATIONWIDE INPATIENT SAMPLE DATABASE. Program No. P0458. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.