Temporal Trends in Hospitalization Rates for Inflammatory Bowel Disease in the 21st Century: a systematic review and population-based cohort study
Date
2022-06-10
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Abstract
Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract. Individuals living with IBD are heavily burdened for life and may require medication reliance, hospitalization, or surgery. There are a plethora of studies investigating hospitalization rates, but literature is highly heterogeneous methodologically and has never been comprehensively synthesized. Therefore, the aim of this thesis is to conduct a systematic review of global IBD hospitalization trends and a population-based Alberta cohort study that will contribute to the literature.Medline and Embase were systematically searched for population-based studies reporting annual IBD, Crohn’s disease (CD), or ulcerative colitis (UC) hospitalizations counts, hospitalization rates per 100,000 persons, or hospitalization rates per 100 IBD population. Using log-linear models, temporal trends in hospitalization rates were analyzed. Random effects meta-analysis pooled country level Average Annual Percentage Change (AAPC). Data were stratified by the epidemiologic stage of a region: Compounding Prevalence (Stage 3) in North America, Western Europe, and Oceania versus Acceleration of Incidence (Stage 2) in Asia, Eastern Europe, and Latin America versus Emergence (Stage 1) in developing countries.Population-based administrative databases from Alberta, Canada, were used to identify a cohort of individuals with IBD from 2002 to 2018. Primary (i.e., most responsible diagnoses) and all-cause IBD hospitalization rates were calculated using the prevalent Alberta IBD population and then compared to rates using the general population as the denominator. Rates were age and sex standardized to the Canadian population. Log-linear models calculated AAPC in hospitalization rates with 95% CI.iiiHospitalization rates for IBD are stabilizing in countries in Stage 3, whereas newly industrialized countries in Stage 2 have rapidly rising hospitalization rates, contributing to an increasing burden on global healthcare systems. In Alberta, IBD hospitalization rates are decreasing for both primary admissions for a flare and all-cause hospitalizations. Differences in temporal trends when assessing hospitalization rates using the general population rather than the IBD prevalent population may be due to the rapidly rising prevalence of IBD. Therefore, calculation of rates using the IBD prevalent population may more accurately represent burden and trends in hospitalization rates.
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Keywords
inflammatory bowel disease, Crohn’s disease, ulcerative colitis, hospitalization rates, epidemiology
Citation
Buie, M. J. (2022). Temporal Trends in Hospitalization Rates for Inflammatory Bowel Disease in the 21st Century: a systematic review and population-based cohort study (Master thesis). University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca .