PULMONARY EMBOLISM MORTALITY AMONG IBD PATIENTS WITH CONCURRENT RHEUMATOLOGICAL DISEASES: A CDC WONDER STUDY (1999-2020)

Abstract BACKGROUND Inflammatory bowel disease is a state of chronic systemic inflammation that leads to an increased risk of thromboembolic events, particularly Pulmonary embolism. The risk increases significantly when these patients have co-existing rheumatological diseases. Therefore, this study aims to examine the manifestation of IBD with concurrent rheumatological disease and mortality from PE in these patients. METHODS Death certificate data were obtained from the CDC-WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database. Adult decedents (≥18 years) were identified by checking the death certificates for ICD-10 codes related to ulcerative colitis, Crohn’s disease, and rheumatological diseases. Three cohorts were then created (Group 1, IBD + PE only, Group 2, IBD + PE + rheumatological diseases, and Group 3, IBD + rheumatological diseases without PE). Age-adjusted Mortality Rates (AAMRs) per 100,000 persons were calculated for the total population and categorized by year, age, sex, and race/ethnicity. Moreover, Annual Percentage Change (APC) was calculated using the Joinpoint Regression Software for each category. RESULTS A total of 8,215 deaths from IBD complicated by PE were identified. Among them, 2,141 (26.13%) had concurrent some rheumatological diseases. AAMR of Group 2 was 6.31 per 100,000 which is significantly higher than Group 1, AAMR of 3.92 per 100,000 and Group 3, 2.84 (RR = 1.63, 95% CI: 1.54–1.72). Women aged ≥65 have an AAMR of 11.29. Regarding the racial demographics, the non-Hispanic blacks have an AAMR of 9.22. Rural residents (AAMR: 8.69). Temporal trends showed a 3.38% annual increase in mortality for the triple-diagnosis group (p < 0.001), with the steepest rise occurring after 2015. CONCLUSION Pulmonary Embolism in IBD Patients with concurrent Rheumatological Diseases who are age ≥65, non-Hispanic Black individuals, living in rural areas had a significantly high mortality burden. These findings suggest the vital role of a multispecialty approach in optimally controlling chronic inflammation and initiating early thromboembolic prophylaxis in these population.