S1832 Healthcare Burden of Intestinal Obstruction in Hospitalized Patients With Crohn’s Disease: A Population-Based Analysis

Introduction: Intestinal obstruction is clinically significant complication of Crohn’s disease (CD), often resulting in surgical intervention and increased healthcare utilization. However, population-level data on the impact of obstruction on hospitalization outcomes among patients with CD are limited. We aimed to evaluate the association of intestinal obstruction with hospital length of stay and total charges in a statewide cohort of hospitalized CD patients. Methods: We performed a population-based cohort study using deidentified, publicly available data from adult hospitalizations to acute care hospitals in Texas (Q1 2016–Q2 2024). Patients with Crohn’s disease (CD) were identified using International Classification of Diseases-10 -CM codes K52.0x under CCSR category DIG011. Elective admissions and interhospital transfers were excluded. The primary exposure was CD with intestinal obstruction (DIG012). The primary outcomes were length of stay and inflation-adjusted total hospital charges. Overlap propensity score weighting was applied; results are reported as adjusted risk ratios (aRR) with 95% confidence intervals (CI). Results: Among 78,858 hospitalizations with Crohn’s disease, 7,651 (9.7%) had a diagnosis of intestinal obstruction. These patients were younger (≥65 years: 19.1% vs 31.4%), more often men (43.5% vs 34.1%), and had a lower comorbidity burden. They also had lower rates of ICU admission (17.0% vs 31.5%) and fewer comorbid conditions, including diabetes, cardiovascular, and renal disease (P < 0.0001). Despite lower baseline acuity, obstruction was associated with significantly increased healthcare utilization: in the overlap-weighted cohort, obstruction was linked to longer hospital stay (mean 5.70 vs 4.55 days; aRR 1.25, 95% CI 1.22–1.29) and higher total charges. These associations remained consistent across subgroups including elderly patients, emergency admissions, and ICU stays. Hospitalizations with obstruction also had higher rates of intestinal procedures but were more often discharged home (86.6% vs 72.2%) and less likely to require chronic care (2.9% vs 10.0%). Conclusion: In a large population-based cohort of hospitalized Crohn’s disease patients, intestinal obstruction was associated with significantly longer hospital stays and higher total charges, despite a lower burden of baseline comorbidity. These findings highlight the disproportionate healthcare impact of obstruction and underscore the need for timely recognition and targeted interventions to mitigate its clinical and economic burden.