S1730 Inflammatory Bowel Disease and Their Psychiatry Comorbidities: Prevalence and Predictors of Adverse Hospital Outcomes: A Nationwide Study

Introduction: Psychiatric disorders frequently coexist with inflammatory bowel disease (IBD), but their influence on hospitalization metrics remains underexplored. We examined the prevalence of psychiatric comorbidities in patients with Crohn’s disease (CD) and ulcerative colitis (UC) and evaluated their association with clinical outcomes and hospital resource utilization. Methods: Using the National Inpatient Sample from 2018 to 2022, we identified adult hospitalizations with a primary diagnosis of CD or UC. We stratified patients based on the presence of psychiatric conditions—including mood disorders, anxiety, PTSD, and substance use disorders. Multivariate models adjusted for demographics, comorbidity burden, income, insurance, and hospital characteristics were used to assess outcomes: length of stay (LOS), total charges, mortality, ICU use, and discharge status. Results: Of 53,705 CD and 103,820 UC hospitalizations, 54.5% and 42.6% respectively, had at least one psychiatric comorbidity. Anxiety (CD 17.1%, UC 20.5%) and depression (CD 13.1%, UC 15.8%) were most common. CD patients with psychiatric illness were more often women (58.2%), aged 18–40 (52.7%), and carried higher comorbidity scores (Charlson index ≥3: 30.4%). UC patients showed similar patterns. Psychiatric comorbidity was independently associated with adverse discharge outcomes. In CD, it reduced the likelihood of routine discharge (aOR 0.90 [0.85–0.95]; P = 0.001) and increased AMA discharges (aOR 2.62 [2.01–3.42]; P < 0.001). UC patients with psychiatric illness had lower odds of routine discharge (aOR 0.92 [0.88–0.98]; P = 0.004) and higher AMA discharges (aOR 1.70 [1.43–2.03]; P < 0.001). While mortality and ICU admissions were unaffected, UC patients with psychiatric conditions had longer LOS (P = 0.001) and higher charges (P = 0.005); this trend was less pronounced in CD. Conclusion: Psychiatric disorders are highly prevalent among hospitalized IBD patients and independently contribute to unfavorable discharge outcomes, particularly AMA discharges. These findings highlight the critical role of inpatient mental health support in managing complex IBD hospitalizations and suggest an opportunity for interdisciplinary care models to improve patient trajectories.