S1522 Crohn’s Disease Rehospitalizations Over a 3-Year Time Period

Introduction: Patients requiring multiple hospitalizations for Crohn’s disease (CD) represent a subset with severe, refractory illness. However, clinical factors contributing to repeat admissions remain undefined. We aimed to characterize CD-related admissions, healthcare costs, and clinical comorbidities associated with repeat hospitalization in a tertiary care setting. Methods: De-identified administrative data from a single tertiary referral hospital were analyzed for CD-related hospital discharges between 2008 and 2010. Admissions were identified using a primary diagnosis of CD. Patient demographics, comorbidities, and hospital charges were assessed. Admissions were categorized as single if a patient had one hospitalization over the study period, and as repeat if the patient was hospitalized more than once. Results: There were 802 total primary CD admissions during the 3-year period: 58% were medical (n = 467) and 42% surgical (n = 335). These admissions were linked to 519 unique CD patients with a mean age of 39 years. Women accounted for 60% of medical and 54% of surgical admissions. Mean ages were comparable among men and women across both single and repeat admission groups. Repeat admissions comprised 52% of all CD hospitalizations but were attributed to only 26% of patients. Of these, 74% were medical and 36% surgical. Women made up 57% of medical and 52% of surgical repeat admissions. Comorbidities differed between single and repeat admission groups. Notably, depression and dysthymia ranked among the top 5 associated diagnoses in repeat admission patients, but were absent from the top 10 in single admission patients. Hospital charges for single admission patients totaled $6.5 million, while repeat admission patients accounted for $11.6 million—representing 64% of total CD-related hospitalization costs. Conclusion: One-quarter of CD patients in this tertiary setting accounted for over half of all CD hospitalizations and nearly two-thirds of associated healthcare charges. Depression and dysthymia were more prevalent among repeat admission patients, suggesting that psychiatric comorbidities may contribute to disease severity and rehospitalization. Further research is warranted to better define this high-risk subgroup and develop targeted treatment strategies, potentially including integrated psychological care.