S1833 Association of Post Procedural Complications and Length of Stay Among Hospitalized Patients With Crohn’s Disease: A Population-Based Cohort Study

Introduction: Crohn’s disease (CD) is a chronic inflammatory bowel condition that often necessitates diagnostic and therapeutic gastrointestinal procedures. Postprocedural or postoperative complications can substantially increase healthcare resource utilization in this population. However, the impact of these complications on hospital-level outcomes among patients with CD remains poorly characterized. In this study, we aimed to evaluate the association between postprocedural digestive system complications and healthcare utilization. Methods: We conducted a population-based cohort study using deidentified, publicly available data on adult hospitalizations to acute care hospitals for CD in Texas from Q1 2016 to Q2 2024. Elective admissions and inter-hospital transfers were excluded. CD hospitalizations were identified using International Classification of Diseases-10 -CM codes (K52.0x) under CCSR category DIG011. The primary exposure was a diagnosis of post procedural or post operative digestive system complications identified using CCSR category DIG024. Primary outcomes included length of stay and inflation-adjusted total hospital charges. Overlap propensity score weighting was applied, and results were reported as adjusted risk ratios (aRR) with 95% confidence intervals. Results: Of 78,858 CD-related hospitalizations, 3,739 (4.7%) had postprocedural complications. Compared to those without complications, these hospitalizations had lower rates of hypertension (28.2% vs 40.1%) and higher rates of malnutrition (53.6% vs 15.2%) (P < 0.0001). In the overlap-weighted cohort, complications were associated with longer hospital stays (8.92 vs 5.73 days; aRR 1.56 [95% CI, 1.49–1.63]) and higher total charges ($131,736 vs $86,833; aRR 1.52 [95% CI, 1.43–1.61]). These findings were consistent across subgroups undergoing colonoscopy with biopsy, small bowel resection, and diagnostic GI endoscopy. Conclusion: Postprocedural complications were associated with significantly longer hospital stays and higher total charges, even after adjustment for baseline characteristics. Our findings highlight the substantial clinical and economic burden of procedural complications in CD and underscore the need for targeted preventive strategies and risk mitigation efforts in this high-risk group.