S1808 Trends, Burden and Impact of Infections on Outcomes in Patients With Crohn’s Disease: Insights From the National Inpatient Sample

Introduction: Patients with Crohn’s disease (CD) face an elevated risk of infections due to underlying chronic inflammation and immunosuppressive therapies. Large-scale, contemporary data on current national trends and the clinical/economic burden of infections in hospitalized CD patients remain limited. This study investigates recent trends, burden, and impact of infections among hospitalized patients with CD. Methods: The National Inpatient Sample (NIS) Database (2016-2022) was used to identify all adult patients with CD. Patients with CD were stratified into 2 groups based on the presence or absence of infections. Data was obtained on patient demographics, comorbidities, type of infection, and clinical outcomes. Outcomes assessed include in-hospital mortality, sepsis, shock, acute kidney injury (AKI), intensive care unit (ICU) stay, blood transfusions, and surgical procedures. A multivariate logistic/linear regression analysis was utilized to assess the impact of infections on these outcomes. Results: Of the 1.3 million patients included in the study, 301,095 (22.9%) developed infections. The most frequent infections were urinary tract infections (UTI) (8.8%), hospital-acquired pneumonia (HAP) (6.6%) and skin/soft tissue infections (5.0%). From 2016 to 2022, rates of infections such as HAP, bacteremia, and cholangitis increased, while rates of Clostridioides difficile infection declined. Infections were associated with significantly worse clinical outcomes, including in-hospital mortality (3.3% vs 1.0%), sepsis (5.2% vs 2.1%), shock (7.3% vs 1.9%), AKI (27.1% vs 14.1%), ICU admissions (6.1% vs 1.9%), blood transfusions (0.6% vs 0.3%), but decreased rates of surgical procedures (1.9% vs 4.4%). After adjusting for confounding factors, patients with infections had higher odds of in-hospital mortality (aOR-2.52, 95% CI-2.35-2.69 P < 0.001), sepsis (aOR-2.4,95% CI-2.28-2.53, P < 0.001), shock (aOR-3.41, 95% CI-3.25-3.57, P < 0.001), AKI (aOR-1.8, 95% CI-1.76-1.85, P < 0.001), ICU admissions (aOR-2.85, 95% CI-2.71-2.99, P < 0.001), blood transfusions (aOR-1.97, 95% CI-1.71-2.27, P < 0.001), and lower odds of surgical procedures (aOR-0.6, 95% CI-0.57-0.65, P < 0.001). Conclusion: Our analysis reveals that infections in hospitalized CD patients are common and associated with worse clinical outcomes and increased healthcare utilization. Our findings underscore the need for targeted prevention and early intervention strategies in this population.