Trends in hospitalization rates for Ulcerative Colitis and Crohn’s Disease in Spain between 1997 and 2012. An observational study

Abstract

AIM: The inflammatory bowel disease is a highly prevalent disorder in Spain. Incident cases have been increasing during the last decades. In this study we sought to determine rates and temporal patterns of hospitalizations related both to ulcerative colitis and Crohn’s disease in a 16-year period in Spain and to characterize temporal patterns in surgical utilization, length of stay, and economic burden of IBD for the same time period.

METHODS: A retrospective study using the national information system for hospital data was performed. All hospital discharges related to ulcerative colitis and Crohn's disease among general population reported during a 16-year period (January 1, 1997 through December 31, 2012) were obtained. Most frequent comorbidities, diagnostic procedures and surgeries were also reported.

RESULTS: A total of 26,948 hospital discharges due to ulcerative colitis and 87,752 due to Crohn´s disease were reported in the 16 years study period in Spain. Mean age was 45.3 (SD = 20.5) and 38.0 (SD = 17.3) years, respectively and 55% and 50% were female, respectively. There were a total of 392 deaths among ulcerative colitis hospitalized patients and 565 among Crohn´s disease patients. The annual hospitalization rate was 3.94 (CI 95% 3.90-3.99) per 100,000 population for ulcerative colitis and 12.84 (CI 95%:12.76-12.93) per 100,000 population for Crohn’s disease. The hospitalization rate significantly increased during the study period in the Crohn’s disease group, but remained constant in the ulcerative colitis group. While hospitalization rate in ulcerative colitis constantly increased with age, it peaked for Crohn´s disease in young adults. Case-fatality rate was higher among ulcerative colitis patients. Hospitalization costs were higher for Crohn´s disease related hospitalizations (€4442; SD=€3708) than for ulcerative colitis (€3930; SD = €3054).

CONCLUSION: The hospitalization rate for Crohn’s disease has significantly increased within a 16-year period in Spain, remaining the hospitalization rate stable for ulcerative colitis. The reported trends in hospitalizations for Crohn´s disease describe an important burden on health and economic cost to the Spanish health system.