Comparing Characteristics and Outcomes in Admissions with Pulmonary Embolism and Inflammatory Bowel Disease: A National Cohort Study

Background Venous thromboembolism (VTE) is a known complication of inflammatory bowel disease (IBD) with significant morbidity and mortality. There is limited data on the effect of having a concomitant diagnosis of IBD on the outcome of patients with pulmonary embolism (PE). Methodology All admissions with PE were identified using the National Inpatient Sample (2016-2021). Patients were then grouped based on the presence or absence of preexisting IBD. Our outcomes of interest included all cause in-hospital mortality, predictors, in-hospital complications, and outcomes in patients with PE and concomitant diagnosis of IBD. Results Between January 01, 2016 and December 31, 2021, of 1,096,499 patients admitted with PE, 9,868 (0.9%) had a diagnosis of IBD. Patients with concomitant IBD and PE were on average younger (59.7± 0.36 years vs 63.1± 0.04 years), more often females (54.2% vs 51.64%), and Caucasian (80.6% vs 68.8%) compared to patients without IBD (all p<0.05). Admissions with PE and IBD had a higher rate of being a current or an ex-smoker (29.7% vs 26.2%; p<0.001) and more likely to have a history of VTE (38.1% vs 34.0%; p<0.001). The IBD cohort had a higher rate of bleeding complications (8.3% vs 6.1%; p<0.001) but a lower rate of respiratory (25.4% vs 27.9%; p<0.05), renal (12.7% vs 14.4%; p<0.05), and neurological failure (3.2% vs 4.6%; p<0.05) and lower utilization of invasive ventilation support (2.2% vs 3.3%; p<0.05). Though the IBD cohort did not have longer lengths of hospital stay, they had higher total hospital charges ($53,136.64 vs $51,796.01; p<0.001). In-hospital mortality in the IBD cohort did not differ significantly from the cohort without IBD (2.6% vs 3.2%; unadjusted odds ratio 0.82 [95% confidence interval 0.62-1.09]; p=0.17, adjusted odds ratio 1.2 [95% confidence interval 0.85-1.76]; p=0.28). Conclusion: In summary, despite some differences in organ failure and complications rate, there was no significant variation for in-hospital mortality in PE admissions with and without IBD. The IBD cohort had higher resource utilization with higher total cost of hospitalization despite having similar length of stays.