S1845 Evaluating the Effect of Coronary Artery Disease on Mortality and Discharge Disposition in Hospitalized Patients With Inflammatory Bowel Disease

Introduction: Coronary artery disease (CAD) is an increasing comorbidity amongst patients with inflammatory bowel disease (IBD), due to the fact that the IBD population continues to age. While CAD is well recognized as a predictor of adverse cardiovascular outcomes, its impact on inpatient trajectories for patients with IBD remains insufficiently characterized. We aimed to assess the association between CAD and key hospitalization outcomes, including age at admission, discharge disposition, and in-hospital mortality, in a nationally representative cohort of patients with IBD. Methods: We performed a cross-sectional analysis of 4,142,365 IBD-related hospitalizations using the National Inpatient Sample (NIS). Patients were stratified based on the presence or absence of CAD. Primary outcomes included routine discharge, transfer to a skilled nursing facility (SNF) or other institution, home health care (HHC) utilization, discharge against medical advice (AMA), and in-hospital mortality. Differences between groups were compared using Chi-square tests, with a 2-tailed P < 0.001 considered statistically significant. Results: CAD was identified in 842,658 (20.3%) of IBD hospitalizations. Compared to patients without CAD (n = 3,299,707), patients with CAD were less likely to be discharged to home (45.0% vs 58.8%, P < 0.001) and more likely to be discharged to SNFs or other facilities (26.8% vs 19.1%, P < 0.001), require HHC (21.9% vs 16.5%, P < 0.001), or die in-hospital (3.2% vs 2.4%, P < 0.001). Interestingly, discharge AMA was observed less frequently in patients with CAD (0.7% vs 1.2%, P < 0.001). Conclusion: Coexisting CAD among hospitalized patients with IBD is associated with significantly worse outcomes, including a 33% relative increase in in-hospital mortality and greater post-acute care utilization. These findings highlight the clinical burden of cardiovascular comorbidity in IBD. The lower rate of discharge AMA in the CAD group may reflect more severe illness or better recognition of care needs, emphasizing the importance of individualized discharge planning. These results support the integration of routine cardiovascular screening and multidisciplinary coordination into IBD care. Future studies should evaluate whether incorporation of cardiovascular assessment can improve outcomes in high-risk populations such as those with IBD.